Article Text

AB0832 Effect of long-term proton pump inhibitors on bone mineral density
  1. H Romdhane,
  2. M Cheikh,
  3. H Ben Nejma,
  4. R Ennaifer,
  5. N Bel Hadj
  1. Gastroenterology and hepatology, Mongi Slim Hospital, TUNIS, Tunisia


Background Proton pump inhibitors (PPI) are widespread nowadays. Recent concerns have emerged about possible bone complications of long-term use of PPIs, such as low bone mineral density (BMD) and an increased risk of fractures.

Objectives The aim of our study was to evaluate the effect of long-term use of PPIs on bone by measuring the BMD in order to estimate the frequency of osteopenia and osteoporosis, and to determine the risk factors associated to this complication.

Methods It was a prospective study including consecutive patients who where taking proton pump inhibitors for at least one year. In all patients we realized a bone densitometry in order to evaluate the bone strength and we calculated the FRAX score to estimate the risk of osteoporotic fracture at ten years.

Results We included 52 patients. The mean age was 49,5 years old. The male-female ratio M/F was 0,48. At least three risk factors were found in more than 50% of the population. The calculated daily calcium intake was insufficient in 94% of the patients. The mean duration of PPIs intake was 45 months. The most frequent indication was gastro esophageal reflux disease (75%). The PPI prescription was appropriate in 94% of the cases. The prevalence of osteopenia and osteoporosis was respectively 52% and 19%. The predictive factors of low BMD were an age ≥50 years old (p=0,03), the menopause (p<0,0001), a calcium intake ≤550 mg/day (p<0,038), and a PPI use duration ≥30 months (p<0,006). The multivariate study could not be undertaken because of co linearity of the factors.

Conclusions The long term PPI use is associated to the risk of bone complications, especially among patients at risk for osteoporosis. It seems reasonable to be more vigilant in prescribing PPIs and use lowest effective dose for patients with appropriate indications, and to screen these complications if necessary.

Disclosure of Interest None declared

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