Treating Kids with Proton Pump Inhibitors Could Increase Fracture Risk

Published on March 19, 2020 by Laurie Villanueva

A newly published study suggests otherwise healthy children may be more likely to suffer bone fractures if they’re treated with proton pump inhibitors, a popular class of heart burn medications that includes prescription and over-the-counter versions of Nexium, Prilosec, and PrevAcid.

Proton Pump Inhibitors Raise Fracture Risk by 20%

The study, which appeared in the Journal of Pediatric Gastroenterology and Nutrition, drew data from the cooperative Pediatric Hospital Information System database on children and adolescents, average age of four years, from 2011 to 2015.

The authors were able to match more than 32,001 care encounters in which a patient received a proton pump inhibitor to an equal number of encounters in which the patient did not. Any patient with complex chronic conditions, or with conditions or medications predisposing to fracture risk, was excluded from the data set.

The study suggested:

  • A significantly higher fracture rate in children exposed to proton pump inhibitors: 1.4% versus 1.2% among those not treated with the drugs.
  • Children taking proton pump inhibitors faced a 20% higher probability of fracture.
  • The upper extremity (arm and hand) was the most common fracture location in both groups. However, children taking proton pump inhibitors were more likely to experience lower extremity fractures.
  • A “class effect” was observed, where the fracture risk was increased with all proton pump inhibitors, not any particular drug or combination of drugs.

“Our study highlights the need to limit the use of PPIs to individuals who are clearly benefiting and for the least duration necessary,” said coauthor Thomas Attard, MD. “Additionally, children who are on these medications long-term warrant ongoing follow up.” The researchers hope the findings will stimulate further research and strategies to limit fracture risk in children who require PPIs for longer periods of time.

Proton Pump Inhibitor Side Effects & Lawsuits

Millions of Americans use proton pump inhibitors like Nexium, Prilosec, and PrevAcid to control heart burn symptoms and other gastric issues related to the overproduction of stomach acid. Because they’re generally considered safe, these medications also rank among the most overprescribed, with many patients taking proton pump inhibitors far longer than recommended or for inappropriate indications.

Previous studies have linked long-term proton pump inhibitor use to a range of serious health consequences, including:

  • Heart attacks
  • Dementia
  • Bone fractures
  • Vitamin B deficiency
  • Low magnesium levels
  • Gastric cancer

A mounting body of research also suggests extended treatment with proton pump inhibitors may be associated with an increased risk of chronic kidney disease, kidney failure, and other renal complications.

More than 13,370 proton pump inhibitor lawsuits have been centralized  the U.S. District Court, District of New Jersey. Plaintiffs involved in the litigation allege that their long-term use of Nexium, Prilosec, PrevAcid, Protonix, and Dexilant resulted in kidney failure and other serious renal problems. They further claim that the drugs’ manufacturers long concealed evidence linking their products to serious renal injuries and failed to provide the public with adequate notice of these risks.

The first bellwether trial of a proton pump inhibitor lawsuit is scheduled to be convened in November 2021.

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