TY - JOUR
T1 - The combined use of anti-peptic agents is associated with an increased risk of osteoporotic fracture
T2 - a nationwide case-control study
AU - Oh, Dong Jun
AU - Nam, Ji Hyung
AU - Lee, Hyun Seok
AU - Moon, Yeo Rae
AU - Lim, Yun Jeong
N1 - Publisher Copyright:
© 2024 The Korean Association of Internal Medicine.
PY - 2024/3
Y1 - 2024/3
N2 - Background/Aims: Long-term use of acid suppressants such as proton pump inhibitors (PPIs) and histamine 2 receptor antagonist (H2RA) has been associated with the risk of osteoporotic fracture. Acid suppressants and muco-protective agents (MPAs) are often used together as anti-ulcer agents. We evaluated the association between the risk of osteoporotic fracture and the combined use of these anti-peptic agents. Methods: A population-based case-control study was conducted by analyzing the Korean National Health Insurance Data from 2014 to 2020. Patients who had been prescribed anti-peptic agents, such as PPI, H2RA, or MPA, were included. Considering the incidence of osteoporotic fractures, the case group (n = 14,704) and control group (n = 58,816) were classified by 1:4 matching based on age and sex. Results: The use of all types of anti-peptic agents was associated with an increased risk of osteoporotic fractures (PPI: hazard ratio [HR], 1.31; H2RA: HR, 1.44; and MPA: HR, 1.33; all p < 0.001). Compared to PPI alone, the combined use of “PPI and H2RA” (HR, 1.58; p = 0.010) as well as “PPI, H2RA, and MPA” (HR, 1.71; p = 0.001) was associated with an increased risk of osteoporotic fracture. However, compared with PPI alone, “MPA and PPI or H2RA” was not associated with an increased risk of osteoporotic fracture. Conclusions: This study found that the combined use of “PPI and H2RA” was associated with a higher risk of osteoporotic fractures. In cases where deemed necessary, the physicians may initially consider prescribing the combination use of MPA.
AB - Background/Aims: Long-term use of acid suppressants such as proton pump inhibitors (PPIs) and histamine 2 receptor antagonist (H2RA) has been associated with the risk of osteoporotic fracture. Acid suppressants and muco-protective agents (MPAs) are often used together as anti-ulcer agents. We evaluated the association between the risk of osteoporotic fracture and the combined use of these anti-peptic agents. Methods: A population-based case-control study was conducted by analyzing the Korean National Health Insurance Data from 2014 to 2020. Patients who had been prescribed anti-peptic agents, such as PPI, H2RA, or MPA, were included. Considering the incidence of osteoporotic fractures, the case group (n = 14,704) and control group (n = 58,816) were classified by 1:4 matching based on age and sex. Results: The use of all types of anti-peptic agents was associated with an increased risk of osteoporotic fractures (PPI: hazard ratio [HR], 1.31; H2RA: HR, 1.44; and MPA: HR, 1.33; all p < 0.001). Compared to PPI alone, the combined use of “PPI and H2RA” (HR, 1.58; p = 0.010) as well as “PPI, H2RA, and MPA” (HR, 1.71; p = 0.001) was associated with an increased risk of osteoporotic fracture. However, compared with PPI alone, “MPA and PPI or H2RA” was not associated with an increased risk of osteoporotic fracture. Conclusions: This study found that the combined use of “PPI and H2RA” was associated with a higher risk of osteoporotic fractures. In cases where deemed necessary, the physicians may initially consider prescribing the combination use of MPA.
KW - Anti-ulcer agents
KW - Histamine H2 antagonists
KW - Osteoporotic fracture
KW - Proton pump inhibitor
UR - http://www.scopus.com/inward/record.url?scp=85186629439&partnerID=8YFLogxK
U2 - 10.3904/kjim.2023.326
DO - 10.3904/kjim.2023.326
M3 - Article
C2 - 38321358
AN - SCOPUS:85186629439
SN - 1226-3303
VL - 39
SP - 228
EP - 237
JO - Korean Journal of Internal Medicine
JF - Korean Journal of Internal Medicine
IS - 2
ER -