ArticleJournal of bone metabolism2018
Proton-pump Inhibitor Use and Fracture Risk: An Updated Systematic Review and Meta-analysis.
Article in Journal of bone metabolism, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 98 citations in OpenAlex.
- Increased Risk of Fractures and Use of Proton Pump Inhibitors in Menopausal Women: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022Pooled it
- Association of Potentially Inappropriate Medications and Geriatric Nutritional Risk Index with Frailty in Elderly Patients with Ischemic Heart Disease.Diagnostics (Basel, Switzerland) · 2026Article
- Impact of Proton Pump Inhibitor Therapy on Bone Mineral Density: An Updated Systematic Review.Cureus · 2026Review
- Cost-effectiveness of RefluxStop for gastroesophageal reflux disease: analysis from an Italian healthcare perspective.BMC gastroenterology · 2026Article
- Cost-Effectiveness of RefluxStop Versus Nissen Fundoplication and Proton Pump Inhibitors for Refractory Gastroesophageal Reflux Disease: A Spanish Healthcare Perspective.PharmacoEconomics - open · 2026Article
- Differential fracture risk among proton pump inhibitors in older adults: evidence network and pharmacovigilance validation.Frontiers in pharmacology · 2026Article
- Cost-effectiveness of RefluxStop compared to proton pump inhibitors and Nissen fundoplication for management of persistent gastroesophageal reflux disease in Norway.Cost effectiveness and resource allocation : C/E · 2025Article
- Regular Proton-Pump Inhibitor Intake is Associated with Deterioration of Peripheral Bone Mineral Density, Microarchitecture, and Strength in Older Patients as Assessed by High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT).Calcified tissue international · 2025Article
- Proton pump inhibitor exposure, trabecular bone score, and BMD: a registry-based cohort study.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Article
- Sex-specific Association of Chronic Proton Pump Inhibitor Use With Reduced Bone Density and Quality.The Journal of clinical endocrinology and metabolism · 2025Article
- The Economic Impact of Introducing RefluxStop for Refractory Gastroesophageal Reflux Disease on the Italian Healthcare System.PharmacoEconomics - open · 2024Article
- Potential Risks Associated With Long-term Use of Proton Pump Inhibitors and the Maintenance Treatment Modality for Patients With Mild Gastroesophageal Reflux Disease.Journal of neurogastroenterology and motility · 2024Review
- Association between exposure to proton pump inhibitors and delirium: a descriptive and disproportionality analysis of VigiBase.BMJ open · 2024Article
- Osseous implications of proton pump inhibitor therapy: An umbrella review.Bone reports · 2024Review
- Effect of long-term proton pump inhibitors on phosphocalcium metabolism and bone mineral density.Future science OA · 2024Article
- Budget Impact of RefluxStop™ as a Treatment for Patients with Refractory Gastro-oesophageal Reflux Disease in the United Kingdom.Journal of health economics and outcomes research · 2024Article
- The association between proton pump inhibitors and hyperparathyroidism: a potential mechanism for increased fracture-results of a large observational cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023Observational
- Pantoprazole-Induced Bone Loss through Gastrin Secretion: A Stereological Study.BioMed research international · 2023Article
- Review
- Proton Pump Inhibitors and Bone Health: An Update Narrative Review.International journal of molecular sciences · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study's objective was to evaluate the association between proton-pump inhibitor (PPI) use and bone fracture incidence and bone mineral density (BMD) by meta-analyzing the estimates reported by epidemiological and cohort studies.
methodsData were acquired from studies identified after a literature search in electronic databases. Odds ratios (ORs), hazard ratios (HRs), and risk ratios (RRs) between PPI use and bone fracture incidence were pooled under the random effects model, and meta-analysis of standardized mean differences between PPI users and controls in cross-sectional values and BMD changes was conducted.
resultsThirty-three studies fulfilled the eligibility criteria. These studies provided data from 2,714,502 individuals with a mean age of 66.91 years (95% confidence interval [CI], 63.37-70.46); 33.21% (95% CI, 30.44-35.99) were males and 64.61% (95% CI, 60.73-68.49) were females. Overall, fracture incidence was 22.04% (95% CI, 16.10-27.97) in PPI users and 15.57% (95% CI, 12.28-18.86) in controls. The overall effect size of the point estimate was 1.28 (95% CI, 1.22-1.35) between PPI use and bone fracture incidence. There was a trend towards increased fracture incidence from short duration use: OR 1.29 (95% CI, 1.19-1.40), medium duration use: OR 1.33 (95% CI, 1.12-1.55) and long duration use: OR 1.62 (95% CI, 1.33-1.90). There was no significant difference in the standardized mean differences between PPI users and controls, either in cross-sectional BMD values or in the BMD change observed in longitudinal studies.
conclusionsPooling of ORs, HRs, and RRs suggested that PPI use might increase fracture risk. However, there was no effect of PPI use on BMD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.