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PPI heartburn drugs 'up hip fracture risk in smokers'

NHS Choices Behind the Headlines, 2012

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Fracture risk is higher from PPIs, but the total risk is low
“Heartburn pills taken by thousands of women ‘raise risk of hip fractures by up to 50 per cent’,” the Daily Mail reported today.
The headline is based on a large new study of drugs called proton pump inhibitors (PPIs), which are commonly used to treat heartburn, acid reflux and ulcers.
The study found that post-menopausal women who regularly took PPIs for at least two years were 35% more likely to suffer hip fracture than non-users, a figure that increases to 50% for women who were current or former smokers.
This was a large, well conducted study that suggests that long-term use of PPIs is associated with a small increase in risk of hip fracture, although the researchers point out that the risk seems to be confined to women with a history of smoking.
Unlike previous research, this study took careful account of other factors that might affect risk such as body weight and calcium intake.
The study was carried out by researchers from Massachusetts General Hospital, Boston University and Harvard Medical School and was funded by the US National Institutes of Health.
Although the Mail’s headline is technically correct, it gives the impression that these drugs carry a very large increase in the risk of hip fracture.
Researchers found that among the women in the study who regularly used PPIs, about two in every 1,000 fractured a hip each year.
They are used for symptoms of heartburn, gastro-oesophageal reflux disease (GORD) and stomach ulcers.