Proton pump inhibitors therapy and risk of hip fracture: a systematic review and meta-analysis

Eur J Gastroenterol Hepatol. 2011 Sep;23(9):794-800. doi: 10.1097/MEG.0b013e328348a56a.


Background and aims: Previous studies have reported inconsistent findings that proton pump inhibitors (PPIs) therapy might increase the risk of hip fracture. We investigated the association between PPIs therapy and hip fracture by a systematic review and meta-analysis.

Methods: We systematically searched PubMed, EMBASE, and the Cochrane Library. We included studies assessing the effects of PPIs on hip fracture. Data from the studies about odds ratio and 95% confidence interval were gathered and summarized.

Results: Seven studies met the inclusion criteria. PPIs therapy was associated with a statistically significant increase of hip fracture risk (pooled odds ratio=1.24; 95% confidence interval: 1.15-1.34; P<0.00001) under a random model. Meanwhile, we found that the effect of PPIs on hip fracture differs in different duration groups.

Conclusion: These results indicate that PPIs therapy might have the potential risk of hip fracture. Different effects on hip fracture in the subgroup analysis do not support a causal relationship between PPIs and hip fracture. Whether the risk exists warrants further investigation.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Drug Administration Schedule
  • Hip Fractures / chemically induced*
  • Humans
  • Middle Aged
  • Proton Pump Inhibitors / administration & dosage
  • Proton Pump Inhibitors / adverse effects*
  • Research Design
  • Risk Assessment / methods
  • Young Adult


  • Proton Pump Inhibitors