The use of PPIs to control upper GIT complaints in patients treated with oral bisphosphonates should be discouraged according to a study published on 13th June, 2011 online in Archives of Internal Medicine.
Bo Abrahamsen, MD, PhD from Institute of Clinical Research, Denmark and colleagues conducted a population-based, national register–based, open cohort observational study of 38 088 new alendronate sodium users with a mean duration of follow-up of 3.5 years. They related risk of hip fracture to recent pharmacy records of refill of prescriptions for alendronate.
They found that for hip fractures, there was a statistically significant interaction with alendronate for PPI use (P < .05). The treatment response associated with complete refill compliance to alendronate was a 39% risk reduction (P < .001) in patients who were not PPI users, while the risk reduction in concurrent PPI users was not significant (P = .06). It was found that decrease of the risk reduction was dependent on dose and age. In contrast, there was no significant impact of concurrent use of histamine H2 receptor blockers.
The authors concluded that the concomitant use of PPI and alendronate was associated with a dose-dependent loss of protection against hip fracture with alendronate in elderly patients.
http://archinte.ama-assn.org/cgi/content/abstract/171/11/998?etoc.
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