Infants Treated with Proton Pump Inhibitors, Other Acid Reflux Drugs More Likely to Suffer Fractures in Childhood

Published on May 5, 2017 by Sandy Liebhard

New research suggests that infants treated with proton pump inhibitors and other acid reflux drugs may be more likely to suffer bone fractures during childhood. The study, which is to be presented this weekend at the 2017 Pediatric Academic Societies Meeting in San Francisco, adds to a growing body of evidence suggesting that antacid medications are not safe for children, especially the very young.

The study was based on an analysis of medical records involving 874,447 healthy children born within the Military Healthcare System (MHS) from 2001 to 2013 who received care within the system for at least 2 years. Roughly 10% were prescribed acid reflux drugs in the first year of life, including proton pump inhibitors (such as Nexium, Prilosec or PrevAcid) or H2-blockers (Zantac, Pepcid etc.)  A small percentage were prescribed both.

Proton pump inhibitors were associated with a 22% increased risk of fracture in childhood. Those who had been prescribed proton pump inhibitors and an H2 blocker were 31% more likely to suffer a childhood bone fracture. Use of H2 blockers alone was not associated with an immediate increased risk. However, risk was seen to increase over time.

Children who began taking antacids the earliest –  6 months of age – had the highest fracture risk. Those who began using the drugs after the age of two were no more likely to suffer bone fractures compared to those who did not take the medications in the first five years of life.

“With many antacids easily available over-the-counter for adults, these medications may seem benign,” the study’s lead author, U.S. Air Force Capt. Laura Malchodi, MD, stated in a press release announcing the findings. “However, our study adds to a growing body of evidence suggesting antacid medications are not safe for children, especially very young children, and should only be prescribed to treat confirmed serious cases of more severe symptomatic gastroesophageal reflux disease (GERD), and for the shortest length of time needed.”

Proton Pump Inhibitor Side Effects

This is far from the first study to suggest that proton pump inhibitors may carry serious risks for both young and old. Previous research has linked their long-term use to an increased risk of dementia, B12 deficiency, low magnesium levels, heart attacks and serious kidney complications, including chronic kidney disease and renal failure.

Numerous proton pump inhibitor lawsuits currently pending in U.S. courts claim that the manufacturers of Nexium, Prilosec and PrevAcid have been aware for years that these medications could potentially harm the kidneys, yet failed to issue appropriate warnings to doctors and patients. Plaintiffs further assert that they could have avoided kidney failure, chronic kidney disease, acute kidney injury and other renal problems had they received proper notice of these risks.

Earlier this year, the U.S. Judicial Panel on Multidistrict Litigation (JPML) denied a petition to centralize all such federal lawsuits in a single U.S. District Court. However, the litigation involving proton pump inhibitors and serious kidney problems continues to grow, and for now cases will progress through courts on an individual basis.