Esomeprazole use is independently associated with significant reduction of BMD: 1-year prospective comparative safety study of four proton pump inhibitors

Elton Bahtiri; Hilmi Islami; Rexhep Hoxha; Hasime Qorraj-Bytyqi; Sylejman Rexhepi; Kreshnik Hoti; Kujtim Thaçi; Shpetim Thaçi; Çağla Karakulak

doi:10.1007/s00774-015-0699-6

Esomeprazole use is independently associated with significant reduction of BMD

1-year prospective comparative safety study of four proton pump inhibitors

Elton Bahtiri, Hilmi Islami, Rexhep Hoxha, Hasime Qorraj-Bytyqi, Sylejman Rexhepi, Kreshnik Hoti, Kujtim Thaçi, Shpetim Thaçi, Çağla Karakulak

Research output: Contribution to journal › Article › Research › peer-review

Abstract

Because of the efficacy of proton pump inhibitors (PPIs), their the use is increasing dramatically. The risk of adverse effects of short-term PPI therapy is low, but there are important safety concerns for potential adverse effects of prolonged PPI therapy. Findings from studies assessing the association between PPI use and bone mineral density (BMD) and/or fracture risk are contradictory. The aim of this study was to prospectively assess potential association of PPI treatment with the 12-month change in BMD of the lumbar spine, femur neck, and total hip. The study was performed in 200 PPI users and 50 PPI nonusers. Lumbar spine (L1–L4), femur neck, and total hip BMD were measured by dual-energy X-ray absorptiometry at the baseline and at 12 months. A total of 209 subjects completed the entire 12 months of the study and were included in the final analysis. A Wilcoxon signed-rank test showed that at 12 months PPI use was associated with statistically significant reductions in femur neck and total hip T scores (Z = −2.764, p = 0.005 and Z = −3.281, p = 0.001, respectively). A multiple linear regression analysis showed that only esomeprazole added significantly to the prediction of total lumbar spine and femur neck T scores (p = 0.048 and p = 0.037, respectively). Compared with the baseline, 12 months of PPI treatment resulted in lower femur neck and total hip BMD T scores. Among the four PPIs studied, esomeprazole was independently associated with significant reduction of BMD, whereas omeprazole had no effects on BMD. Considering the widespread use of PPIs, BMD screening should be considered in the case of prolonged PPI use.

Original language	English
Pages (from-to)	571-579
Number of pages	9
Journal	Journal of Bone and Mineral Metabolism
Volume	34
Issue number	5
DOIs	https://doi.org/10.1007/s00774-015-0699-6
Publication status	Published - 1 Sep 2016
Externally published	Yes

Fingerprint

Esomeprazole

Proton Pump Inhibitors

Bone Density

Safety

Femur Neck

Pelvic Bones

Spine

Hip

Omeprazole

Bone Fractures

Photon Absorptiometry

Nonparametric Statistics

Cite this

Bahtiri, E., Islami, H., Hoxha, R., Qorraj-Bytyqi, H., Rexhepi, S., Hoti, K., ... Karakulak, Ç. (2016). Esomeprazole use is independently associated with significant reduction of BMD: 1-year prospective comparative safety study of four proton pump inhibitors. Journal of Bone and Mineral Metabolism, 34(5), 571-579. https://doi.org/10.1007/s00774-015-0699-6

Bahtiri, Elton ; Islami, Hilmi ; Hoxha, Rexhep ; Qorraj-Bytyqi, Hasime ; Rexhepi, Sylejman ; Hoti, Kreshnik ; Thaçi, Kujtim ; Thaçi, Shpetim ; Karakulak, Çağla. / Esomeprazole use is independently associated with significant reduction of BMD : 1-year prospective comparative safety study of four proton pump inhibitors. In: Journal of Bone and Mineral Metabolism. 2016 ; Vol. 34, No. 5. pp. 571-579.

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title = "Esomeprazole use is independently associated with significant reduction of BMD: 1-year prospective comparative safety study of four proton pump inhibitors",

abstract = "Because of the efficacy of proton pump inhibitors (PPIs), their the use is increasing dramatically. The risk of adverse effects of short-term PPI therapy is low, but there are important safety concerns for potential adverse effects of prolonged PPI therapy. Findings from studies assessing the association between PPI use and bone mineral density (BMD) and/or fracture risk are contradictory. The aim of this study was to prospectively assess potential association of PPI treatment with the 12-month change in BMD of the lumbar spine, femur neck, and total hip. The study was performed in 200 PPI users and 50 PPI nonusers. Lumbar spine (L1–L4), femur neck, and total hip BMD were measured by dual-energy X-ray absorptiometry at the baseline and at 12 months. A total of 209 subjects completed the entire 12 months of the study and were included in the final analysis. A Wilcoxon signed-rank test showed that at 12 months PPI use was associated with statistically significant reductions in femur neck and total hip T scores (Z = −2.764, p = 0.005 and Z = −3.281, p = 0.001, respectively). A multiple linear regression analysis showed that only esomeprazole added significantly to the prediction of total lumbar spine and femur neck T scores (p = 0.048 and p = 0.037, respectively). Compared with the baseline, 12 months of PPI treatment resulted in lower femur neck and total hip BMD T scores. Among the four PPIs studied, esomeprazole was independently associated with significant reduction of BMD, whereas omeprazole had no effects on BMD. Considering the widespread use of PPIs, BMD screening should be considered in the case of prolonged PPI use.",

keywords = "Bone mineral density, Calcium, Osteoporosis, Proton pump inhibitors",

author = "Elton Bahtiri and Hilmi Islami and Rexhep Hoxha and Hasime Qorraj-Bytyqi and Sylejman Rexhepi and Kreshnik Hoti and Kujtim Tha{\cc}i and Shpetim Tha{\cc}i and {\cC}ağla Karakulak",

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Bahtiri, E, Islami, H, Hoxha, R, Qorraj-Bytyqi, H, Rexhepi, S, Hoti, K, Thaçi, K, Thaçi, S & Karakulak, Ç 2016, 'Esomeprazole use is independently associated with significant reduction of BMD: 1-year prospective comparative safety study of four proton pump inhibitors', Journal of Bone and Mineral Metabolism, vol. 34, no. 5, pp. 571-579. https://doi.org/10.1007/s00774-015-0699-6

Esomeprazole use is independently associated with significant reduction of BMD : 1-year prospective comparative safety study of four proton pump inhibitors. / Bahtiri, Elton; Islami, Hilmi; Hoxha, Rexhep; Qorraj-Bytyqi, Hasime; Rexhepi, Sylejman; Hoti, Kreshnik; Thaçi, Kujtim; Thaçi, Shpetim; Karakulak, Çağla.

In: Journal of Bone and Mineral Metabolism, Vol. 34, No. 5, 01.09.2016, p. 571-579.

Research output: Contribution to journal › Article › Research › peer-review

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T2 - 1-year prospective comparative safety study of four proton pump inhibitors

AU - Bahtiri, Elton

AU - Islami, Hilmi

AU - Hoxha, Rexhep

AU - Qorraj-Bytyqi, Hasime

AU - Rexhepi, Sylejman

AU - Hoti, Kreshnik

AU - Thaçi, Kujtim

AU - Thaçi, Shpetim

AU - Karakulak, Çağla

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AB - Because of the efficacy of proton pump inhibitors (PPIs), their the use is increasing dramatically. The risk of adverse effects of short-term PPI therapy is low, but there are important safety concerns for potential adverse effects of prolonged PPI therapy. Findings from studies assessing the association between PPI use and bone mineral density (BMD) and/or fracture risk are contradictory. The aim of this study was to prospectively assess potential association of PPI treatment with the 12-month change in BMD of the lumbar spine, femur neck, and total hip. The study was performed in 200 PPI users and 50 PPI nonusers. Lumbar spine (L1–L4), femur neck, and total hip BMD were measured by dual-energy X-ray absorptiometry at the baseline and at 12 months. A total of 209 subjects completed the entire 12 months of the study and were included in the final analysis. A Wilcoxon signed-rank test showed that at 12 months PPI use was associated with statistically significant reductions in femur neck and total hip T scores (Z = −2.764, p = 0.005 and Z = −3.281, p = 0.001, respectively). A multiple linear regression analysis showed that only esomeprazole added significantly to the prediction of total lumbar spine and femur neck T scores (p = 0.048 and p = 0.037, respectively). Compared with the baseline, 12 months of PPI treatment resulted in lower femur neck and total hip BMD T scores. Among the four PPIs studied, esomeprazole was independently associated with significant reduction of BMD, whereas omeprazole had no effects on BMD. Considering the widespread use of PPIs, BMD screening should be considered in the case of prolonged PPI use.

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