Long-term use of proton pump inhibitors adversely affects minerals and vitamin metabolism, bone turnover, bone mass, and bone strength

J Basic Clin Physiol Pharmacol. 2021 Oct 25;33(5):567-579. doi: 10.1515/jbcpp-2021-0203. eCollection 2022 Sep 1.

Abstract

Notwithstanding, proton pump inhibitors (PPIs) are one of the most excellent options for different anti-secretory therapy in terms of improved symptomatic outcomes, numerous epidemiological and cohort studies provide evidence of an association between long-term proton PPIs use and increased fracture risk among users. The present attempt aimed to summarize the effect of long-term use of PPIs on musculoskeletal systems by considering the recent claims of different research groups to understand the risk of osteopenia and osteoporosis and to determine the risk factors associated with these complications. We extracted data from various systematic reviews and meta-analyses, cross-sectional studies, prospective studies, case-control studies, cohort studies, and in-vivo and in-vitro studies to observe the consequence of long-term PPIs uses over the patient's bone health. Recent findings suggested that long-term use of PPIs plays an introductory and cabalistic role in the development of osteoporosis mostly hip fractures by disturbing numerous biological pathways and thus able to set up a link between over-prescription of PPIs and bone loss. Frequent administration of PPIs is associated with a significantly worse outcome to bone mineral density (BMD) profile and produce a negative impression on bone health. Since, there are limited data to determine the association of PPIs use and change in BMD, recommending further studies to find out this dissertation.

Keywords: bone fracture; bone mineral density (BMD); osteopenia; osteoporosis; proton pump inhibitors (PPIs).

Publication types

  • Review

MeSH terms

  • Bone Density*
  • Bone Remodeling
  • Cross-Sectional Studies
  • Humans
  • Minerals
  • Osteoporosis* / chemically induced
  • Prospective Studies
  • Proton Pump Inhibitors / adverse effects
  • Protons
  • Vitamins / pharmacology

Substances

  • Minerals
  • Proton Pump Inhibitors
  • Protons
  • Vitamins