Older women who take Nexium or other proton pump inhibitors may be more likely to suffer osteoporotic fractures compared to those who use alternative heartburn medications, according to a recently published study.
The research, which appeared online in Bone on February 29th, utilized nationwide population-based study data from the South Korean National Health Insurance Services, and focused on women age 66 or older who had taken either proton pump inhibitors or histamine-2 receptor antagonists (H2RAs).
A case group consisting of 8,903 women who had experienced osteoporotic fractures during follow-up was matched to a control group consisting of 44,515 patients who had not. Rheumatoid arthritis, chronic kidney disease, chronic obstructive pulmonary disease, Cushing syndrome, vitamin D deficiency, chronic liver disease, and diabetes mellitus were more prevalent among the case group
According to the study authors, any proton pump inhibitor use was associated with a 13% increased risk of osteoporotic fracture compared to those who only used H2Ras. Women who took proton pump inhibitors for a year or more saw their risk increase by 30%. However, higher doses did not correlate with a higher risk.
While recent proton pump inhibitor use (within the year) was associated with greater risk, remote use (within the proceeding year) was not. The effect of proton pump inhibitor treatment did not differ in accordance with major osteoporosis risk factors.
“The risk of osteoporotic fracture may be mitigated in women with gastrointestinal diseases who need acid inhibitor treatments and are at a high risk of osteoporotic fracture by prescribing PPI for minimal durations or replacing PPI with H2RA,” the study authors concluded.
Proton pump inhibitors, including prescription and over-the-counter versions of Nexium, Prilosec, PrevAcid, are among the mostly-widely used medications in the world. Though they are only indicated for the short-term treatment of heartburn and other gastric issues related to the overproduction of stomach acid, studies have shown that many people use proton pump inhibitors far longer than recommended or for inappropriate indications.
In addition to fractures, previous studies have linked long-term use of Nexium and other proton pump inhibitors to a range of serious health consequences, including:
Other research suggests extended treatment with Nexium or similar drugs may contribute to the development of chronic kidney disease, kidney failure, and other renal complications.
More than 13,370 proton pump inhibitor lawsuits are currently pending in a multidistrict litigation underway in the U.S. District Court, District of New Jersey. The majority of plaintiffs 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 have long known that their products could harm the kidneys, but endeavored to conceal evidence of these side effects and failed to provide doctors and patients with appropriate safety warnings.
The first bellwether trial of a proton pump inhibitor lawsuit is scheduled to be convened in November 2021.