Article

Calcified Tissue International

, Volume 84, Issue 1, pp 13-19

Increase in Vertebral Fracture Risk in Postmenopausal Women Using Omeprazole

  • Christian RouxAffiliated withRheumatology Department, AP-HP Cochin Hospital, Paris Descartes University Email author 
  • , Karine BriotAffiliated withRheumatology Department, AP-HP Cochin Hospital, Paris Descartes University
  • , Laure GossecAffiliated withRheumatology Department, AP-HP Cochin Hospital, Paris Descartes University
  • , Sami KoltaAffiliated withRheumatology Department, AP-HP Cochin Hospital, Paris Descartes University
  • , Tilo BlenkAffiliated withCentre of Muscle and Bone Research, Charité – University Medicine Berlin, Campus Benjmain Franklin, Free and Humboldt University
  • , Dieter FelsenbergAffiliated withCentre of Muscle and Bone Research, Charité – University Medicine Berlin, Campus Benjmain Franklin, Free and Humboldt University
  • , David M. ReidAffiliated withDepartment of Medicine and Therapeutics, University of Aberdeen
  • , Richard EastellAffiliated withAcademic Unit of Bone Metabolism, University of Sheffield
  • , Claus C. GlüerAffiliated withMedizinische Physik, Klinik für Diagnostische Radiologie, Universitätsklinikum Schleswig-Holstein

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Abstract

Proton pump inhibitors are taken by millions of patients for prevention and treatment of gastroesophageal diseases. Case-control studies have suggested that use of omeprazole is associated with an increased risk of hip fractures. The aim of this prospective study was to assess the risk of vertebral fractures in postmenopausal women using omeprazole. We studied 1,211 postmenopausal women enrolled in the Osteoporosis and Ultrasound Study from the general population. Information on omeprazole and other risk factors for fractures including prevalent fractures and bone mineral density was obtained at baseline. Vertebral fractures were assessed on X-rays obtained at baseline and at the end of the 6-year follow-up and analyzed centrally. At baseline, 5% of this population was using omeprazole. Age-adjusted rates for vertebral fractures were 1.89 and 0.60 for 100 person-years for omeprazole users and nonusers, respectively (P = 0.009). In the multivariate analysis, omeprazole use was a significant and independent predictor of vertebral fractures (RR = 3.50, 95% CI 1.14–8.44). The other predictors were age higher than 65 years (RR = 2.34, 95% CI 1.02–5.34), prevalent vertebral fractures (RR = 3.62, 95% CI 1.63–8.08), and lumbar spine T score ≤ −2.5 (RR = 2.38, 95% CI 1.03–5.49). Omeprazole use is associated with an increased risk of vertebral fractures in postmenopausal women. Further studies are required to determine the mechanism of the association between the underlying gastric disease, omeprazole use, and risk of osteoporotic fractures.

Keywords

Osteoporosis Proton pump inhibitor Vertebral fracture Postmenopausal women