Long-term
use of some of the most common
drugs prescribed to tackle
stomach acid problems may
be weakening people's bones.
Researchers
found a significantly increased
risk of hip fracture among
patients taking 'proton pump
inhibitors' for more than
a year.
They said
doctors should consider the
risk when prescribing such
drugs.
The University
of Pennsylvania study findings
appear in the Journal of the
American Association.
Millions
of people in the UK take drugs
such as omeprazole, frequently
on a continuous basis, and
they are even available directly
from pharmacies.
Some research has already suggested
that taking the drugs could
interfere with the body's ability
to absorb calcium to keep bones
strong.
The Jama
study looked at a large group
of records from the UK General
Practice Research Database.
All the people involved were
aged over 50, and some had
been taking proton pump inhibitors
(PPI).
The researchers
found that people who had
been taking the drugs for
more than a year - not an
uncommon scenario - had a
44% greater risk of suffering
a hip fracture.
Taking the
drugs for even longer seemed
to increase the risk yet further.
Fall can
be fatal
Hip fracture
is one of the most significant
causes of severe disability
in older people - up to one
in five people who suffer
a fracture following a fall
die within 12 months.
The costs
to the NHS of hip fractures
are also huge, not only immediately
afterwards but in the cost
of emergency hip replacement
operations.
The researchers
said that while the link between
increased risk and taking
the medication appeared clear,
it was possible that the type,
general health and age of
patients taking regular PPI
medication might contribute
to the difference in some
way.
They wrote:
"Physicians should be aware
of this potential association
when considering PPI therapy
and should use the lowest
effective dose for patients
with appropriate indications."
Research
'overdue'
They also
suggested doctors should make
sure that elderly patients
took calcium supplements alongside
the drugs to try to lower
the risk.
Since 2004,
omeprazole has been available
directly from UK chemists
without prescription, although
at a lower than the normal
prescribed dose, and, accompanied
by guidelines which recommend
it only for short periods.
Dr Denise
Hansford, a senior lecturer
in pharmacy at the Robert
Gordon University in Aberdeen,
said that research into how
patients fared under this
reclassification was 'overdue'.
She added
that so far, her research
had suggested relatively few
patients were taking advantage
of the new arrangements to
obtain proton pump inhibitors.
'Long
way short'
Ken McColl,
a professor of gastroenterology
at Glasgow University, said
that the study did not prove
that the drugs were the cause.
He pointed
out that many people with
arthritis and other joint
problems - who were already
more prone to hip fractures
- would be taking large doses
of painkillers known to cause
acid indigestion.
He added
that they would therefore
would be more likely to be
taking the proton pump inhibitor
drugs to deal with it.
Although
the study authors had adjusted
their results to take account
of this, he said, there was
still the possibility that
the results could be skewed.
"While this
raises some interesting issues."
he said, "it is a long way
short of proving that PPIs
are causing this."