Up to 6 mos PPI therapy may not affect bone health

Research recently published in the seminal journal Gastroenterology failed to find evidence of alterations in key markers of bone formation and metabolism in postmenopausal women on PPI’s. The study examined calcium absorption, serum or urine mineral levels, parathyroid hormone, Vitamin D status, or bone-mineral density with 6 months of PPI therapy.   The prospective double-blind study followed 115 healthy, women between the ages of 45 and 75 with normal calcium intake and Vitamin D levels over 4 years.  Plasma levels of procollagen type 1 N-terminal peptide (P1NP) and C-terminal telopeptide of type 1 collagen (CTX) were also measured at baseline, and again at weeks 13 and 26. At 12 centers across the United States, women were randomized to receive dexlansoprazole 60 mg, esomeprazole 40 mg, or placebo daily for 26 weeks.  There were no significant within-group differences in bone turnover markers between baseline and week 26.  Researchers say that the lack of significant increase in markers of bone turnover in the PPI groups is encouraging.  PPI’s have been linked with osteoporotic fractures, but this study did not find a mechanism by which PPIs would cause osteoporosis. Recognizing that osteoporosis is a long-term process, critics cite the short study duration as a limitation, and the lack of data on bone turnover beyond 26 weeks. Long term follow-up of the same group would be advantageous in understanding this issue.

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