1 Feb: Postmenopausal women taking indigestion pills face increased risk of hip fracture

Postmenopausal women who take indigestion drugs called proton pump inhibitors (PPIs) face an increased risk of hip fractures, a study has found.

PPIs are commonly taken by people with osteoarthritis and rheumatoid arthritis alongside non-steroidal anti-inflammatory drugs (NSAIDs) to protect the stomach against side-effects such as digestive problems (stomach upsets, indigestion or damage to the lining of the stomach).

Researchers at Massachusetts General Hospital looked at data on 79,899 postmenopausal women, all of whom provided regular information on their use of PPIs as part of the Nurses' Health Study from 2000 to 2008.

A total of 893 hip fractures occurred during that time at a rate of 2.02 fractures per 1,000 person years among PPI users, compared with just 1.51 fractures per 1,000 person years among non-users.

Women who regularly used PPIs for at least two years were 35 per cent more likely to suffer a hip fracture than non-users, and an individual's risk of fracture increased with long-term use of the drugs.

The researchers also observed that current and former smokers who used PPIs had a particularly high risk of hip fractures, being 50 per cent more likely to suffer a fracture than women who did not smoke and did not take indigestion drugs.

Publishing their findings in the British Medical Journal, the study authors concluded: "Regular use of PPI was associated with increased risk of hip fracture among postmenopausal women, with the strongest risk observed in individuals with the longest duration of use or with a history of smoking.

"Our results, considered in the context of a systematic review of prior studies, provide compelling evidence of a significant association between PPI use and fracture."

The researchers added that their findings suggest an absolute increase in risk of five hip fractures per 10,000 person years among PPI users.

Dr John Stevenson, who is on the medical advisory council of the British Menopause Society, said that the study confirmed suspicions about PPIs and their impact on fracture risk, but that the absolute risk was "small".

"Women should not be put off using proton pump inhibitors if they are needed, but these results provide yet another reason not to smoke," he added.

A spokesman for Arthritis Research UK said: "This is worrying news for the millions of people who have osteoarthritis and rheumatoid arthritis and take PPIs to protect their stomachs against the side-effects of their painkilling medication; however the risks are small. If people are concerned they should contact their GP."