concerns of the leaders of the United States of reinforcing health, new Korean research suggests that a long-term use of popular heartburn such as tramadol, Prevacid and Nexium drug is linked to an increased risk of fractures.
Scientists conducting a meta-analysis of 11 studies published between 1997 and 2011 (PPI) Proton pump inhibitors, which reduce the production of acid stomach, found to be associated with a 29 percent risk increased fracture. This included a higher risk of 31% of hip fractures and a risk of 54 per cent increased of vertebral fractures.
Another class of heartburn medication called antagonists H2 or H2 blockers - receptors which include names such as Zantac and Pepcid - were not significantly related to the failure risk, according to the authors of the study. H2 blockers, however, are less powerful than the IPP to remove acid production, not blocking that approximately 70 per cent rather than estimates 98 percent that can be blocked by IPP.
"It is difficult to uniformly say what is the absolute risk because the risk of fracture shows many differences, the age, sex, race and ethnicity," said lead author the study Dr. Chun-Sick Eom, a clinical instructor in the Department of family medicine at Hallym University in ChuncheonCorée hospital.
"Clinicians should carefully consider their decision to prescribe PPIs for patients, at high risk of fracture, especially the women aged over 65 years", he added. "We recommend that doses of a drug would be chosen thoughtfully taking into account of what is necessary to achieve the desired therapeutic objectives."
In addition, a subset of the quality of the studies - and adjustment for at least five variables that could also influence studies of fracture risk - showed an increase in fractures in people taking with H2 blockers. For this reason, the authors of the study also recommended a more comprehensive study on the subject.
The study is published in May / June issue of the annals of family medicine.
In May 2010, the U.S. Food and Drug Administration decided that the PPI would carry a warning on their labels on their possible fracture risk. Drugs - including esomeprazole (Nexium), dexlansoprazole (Dexilant), omeprazole (tramadol, Zegerid), lansoprazole (Prevacid), pantoprazole (Protonix) and Rabeprazole (Aciphex) - are used to treat ulcers of stomach and small intestine disease gastroesophageal reflux disease (GERD) and inflammation of the esophagus.
Acid suppressors are the second main drug used in the world, said MoE, with sales to United States in 2005 totalling almost $ 27 billion.
IPP and H2 blockers are considered as having different effects on bone metabolism, Moe, noted for their disparate fracture risk. IPP may impair the ability of the gut to absorb calcium - a process which is helped by acid - and the process of growth of new bone cells.
MoE has acknowledged that the study was limited by lack of access to individual data on nutrients which could influence the risk of fracture of the participants.
An editorial accompanying the study noted that the essential was to balance the absolute risks and benefits - for physicians to reduce consumption PPI each time than necessary, but do not worry about their use for patients such as those with acute gastric ulcers or other potentially fatal conditions.
Dr. David Bernstein, Chief of the division of Gastroenterology at North Shore University Hospital in Manhasset, New York, said that while the study was observation, it should encourage doctors to question the ongoing need for patients to take medications for acid suppression.
"We must look at case-by-case basis," said Bernstein. "If someone is uncontrollable reflux and needs long-term PPI therapy, they probably will get." They feel better, and it is easy. ?
However, "at one point, the doctor and the patient need to think in a different strategy - stop medication or change medications," he added. "We should the minimum amount for the patient get the property and then stop".
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