Posted on 12/27/2006 10:17:54 AM PST by Graybeard58
CHICAGO -- Taking such popular heartburn drugs as Nexium, Prevacid or Prilosec for a year or more can raise the risk of a broken hip markedly in people over 50, a large study in Britain found.
The study raises questions about the safety of some of the most widely used and heavily promoted prescription drugs on the market, taken by millions of people.
The researchers speculated that when the drugs reduce acid in the stomach, they also make it more difficult for the body to absorb bone-building calcium. That can lead to weaker bones and fractures.
Hip fractures in the elderly often lead to life-threatening complications. As a result, doctors should make sure patients have good reason to stay on heartburn drugs long term, said study co-author Dr. Yu-Xiao Yang of the University of Pennsylvania School of Medicine.
"The general perception is they are relatively harmless," Yang said. Some people find relief from heartburn with over-the-counter antacids such as Tums and Rolaids. But for others, those medicines do not work well.
Moreover, heartburn can be more than a source of discomfort. People with chronic heartburn can develop painful ulcers in the esophagus, and in rare cases, some can end up with damage that can lead to esophageal cancer.
Dr. Sandra Dial of McGill University in Montreal, who was not involved in the study but has done similar research, said patients should discuss the risks and benefits with their doctors and taper off their use of these medicines if they can.
Nexium, Prevacid and Prilosec are members of a class of drugs known as proton pump inhibitors. The study found a similar but smaller risk of hip fractures for another class of acid-fighting drugs called H2 blockers. Those drugs include Tagamet and Pepcid.
The study, published in Wednesday's Journal of the American Medical Association, looked at medical records of more than 145,000 patients in England, where a large electronic database of records is available for research. The average age of the patients was 77.
The patients who used proton pump inhibitors for more than a year had a 44 percent higher risk of hip fracture than nonusers. The longer the patients took the drugs, the higher their risk.
The biggest risk was seen in people who took high doses of the drugs for more than a year. That group had a 2½ times greater risk of hip fractures than nonusers.
Yang said that for every 1,262 elderly patients treated with the drugs for more than a year, there would be one additional hip fracture a year attributable to the drugs. For every 336 elderly patients treated for more than a year with high doses, there would be one extra hip fracture a year attributable to the drugs.
Dr. Doug Levine of AstraZeneca PLC, which makes Nexium and Prilosec, said the study does not prove that proton pump inhibitors cause hip fractures. It merely suggests a potential association, he said. Doctors need to monitor their patients for proper dosage and watch how long they take the drugs, Levine said.
Julia Ellwanger, a spokeswoman for TAP Pharmaceutical Products Inc., which markets Prevacid, said proton pump inhibitors' safety has been well-established by rigorous studies, and the new study does not prove or disprove a connection to hip fractures.
Dr. Alan Buchman of Northwestern University, who was not involved in the research, said the study should not change medical practice, since doctors already should be monitoring the bone density of elderly people taking the drugs and recommending calcium-rich diets to all patients.
"Most people are not taking enough calcium to start with," he said. He also wondered if a similar result would have been found in a sunny climate, because vitamin D from sunshine helps with calcium absorption.
Also, Buchman said it not known whether the acid-fighting drugs prevent esophageal cancer. He said the risk of esophageal cancer has been exaggerated in the marketing of these drugs.
"I think the risk has been overplayed and scared the community," Buchman said.
Heartburn medicines are heavily are advertised in "Ask your doctor about ..." commercials in this country, particularly during the evening news.
Nexium is the third biggest selling drug in the world, behind the cholesterol medicine Lipitor and blood thinner Plavix, with global sales totaling $5.7 billion last year, according to IMS Health, which tracks drug sales.
Yang and his co-authors disclosed in the paper that they have worked as consultants and received speaking fees from companies making acid-fighting drugs. The study was funded by the National Institutes of Health and the American Gastroenterological Association/GlaxoSmithKline Glaxo Institute for Digestive Health.
Men in the study had a higher drug-associated risk of hip fracture than women, possibly because women may be more aware of osteoporosis and may get more calcium in their diets, Yang said. He plans more research on whether calcium-rich diets or calcium supplements can prevent the problem.
ping
damnit, we're all gonna die. Again.
The sky is falling!
I'm taking Prilosec now and would rather break both hips than go without. If I'm not taking my little purple pill everyday I am simply disabled by heartburn pain. I get heartburn when I drink a glass of water.
I used to have terrible heart burn until I quit drinking alcoholoic beverages, I'm not saying that's your problem but it worked for me, I haven't had heart burn in more than 25 years.
I'm with you. I don't care what the side effects are. My heart burn is so painful that I can't do anything at all when it kicks in. Had it in some shape or form since I was 16. By the time I was 22 I was seeking medical help and I thanked God Almighty when proton pump inhibitors hit the market. It was like a miracle for me and I ain't givin' 'em up!
Nope, don't drink. I also have diabetes, HPB, chronic pancreatitis and Kidney Cancer. GERD is what bothers me the most!
I always thought heartburn was a symptom not a disease. Silly me, a pill is always better and how much does medicine really cure anyway. Seems that pills only mask since you can never go off of them. Must be it is good for capitalism.
This "pill" works.
Some people, like me, produce too much acid. It comes up. Aside from the pain, it will eventually erode your esophagus and cause esophageal cancer.
Thats what happened to my Pops. Had he had this "pill" everyday, his acid would be kept down and his erosions would not have taken place and his cancer would not have developed in his esophagus.
he would not have died ~ at least not from this cause...
Same here, I don't what the side affects are. I will pay premium price as well.
Yea, I know what you are saying. I had heartburn for approx 5 years and took em for a while. I just refused to believe that it was something I had to live with. I believed it was a symptom and after 5 years finally it was discovered I had H-Pylori. High dose of antibotics took care of both problems. That was probably 10 years ago. Until Dr's treat heartburn as a symptom and 'cure' the cause, there will always be a purple pill. Besides it make folks rich. But I do understand what you are saying.
Erm,
I actually write a GERD diet for the MR/DD clients with esophageal problems and yeah,
Peppers and beer ain't gonna help ;P
I am glad to know no federal money goes to scientists. LOL
LOL You mean like NASA???
Surely, you are not one that complains about AIDS research and federal money then--are you? Or, is it only research that benefits you that you can support? You know, like all those on FR who believe they do not receive from the government trouth!
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.