RESUMO
BACKGROUND:Whether a long-term use of acid-suppressive medication for over 3 years can increase the risk of fractures, remains controversial. OBJECTIVE:To systematical y review the effect of acid-suppressive medication on fracture risk. METHODS:Clinical trials about the relationship of acid-suppressive medication use and risk of osteoporosis-related fractures were searched in MEDLINE, Cochrane Library, EMbase, and CNKI database. We also manual y searched some published and unpublished references. Study selection and assessment, data col ection and analyses were undertaken by two reviewers independently. The Cochrane Col aboration’s RevMan 5.0 software was used for data analyses. RESULTS AND CONCLUSION:After a comprehensive search, 11 original clinical trials were included in this meta-analysis, including 3 nested case-control studies, 5 case-control studies, and 3 cohort studies. Patients with fractures were more likely than controls to have previously received supply of proton pump inhibitors [odds ratio (OR)=1.29, 95%confidence interval (CI) (1.18-1.41), P<0.001]. The meta-analysis did not find a significant difference in the patients who received H2 receptor antagonists [OR=1.10, 95%CI (0.99-1.23), P=0.34]. A long-term use of proton pump inhibitors is associated with an increased risk of fracture in elderly persons already at a risk for osteoporosis.