Nexium Linked To Hip Fractures
<div class="IPBDescription">more than 145,000 patients in England researched</div><!--quoteo--><div class='quotetop'>QUOTE</div><div class='quotemain'><!--quotec--><a href="http://www.msnbc.msn.com/id/16358462" target="_blank"><!--sizeo:4--><span style="font-size:14pt;line-height:100%"><!--/sizeo-->Heartburn drugs tied to hip-fracture risk<!--sizec--></span><!--/sizec--></a>
<!--sizeo:3--><span style="font-size:12pt;line-height:100%"><!--/sizeo-->Nexium, Prilosec may make it harder for body to absorb calcium, study says<!--sizec--></span><!--/sizec-->
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.
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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. “They often are used without a clear or justified indication for the treatment.”
Some people find relief from heartburn with over-the-counter antacids such as Tums, Rolaids and Maalox. For others, these 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, adding that doctors need to monitor their patients for proper dosage and watch how long they take the drugs.
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 second-biggest-selling drug in the world, behind the cholesterol medicine Lipitor, with global sales totaling $4.6 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.<!--QuoteEnd--></div><!--QuoteEEnd-->
Two questions come to mind ... do the British get enough calcium daily, or perhaps their culture, as a rule, ingests much less than say, the U.S., throwing the results of this reasearch off?
And could the weather indeed be a factor, because as noted England lacks the sunshine necessary for the Vitamin D which aids calcium absorption?
<!--sizeo:3--><span style="font-size:12pt;line-height:100%"><!--/sizeo-->Nexium, Prilosec may make it harder for body to absorb calcium, study says<!--sizec--></span><!--/sizec-->
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.
Story continues below ↓ advertisement
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. “They often are used without a clear or justified indication for the treatment.”
Some people find relief from heartburn with over-the-counter antacids such as Tums, Rolaids and Maalox. For others, these 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, adding that doctors need to monitor their patients for proper dosage and watch how long they take the drugs.
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 second-biggest-selling drug in the world, behind the cholesterol medicine Lipitor, with global sales totaling $4.6 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.<!--QuoteEnd--></div><!--QuoteEEnd-->
Two questions come to mind ... do the British get enough calcium daily, or perhaps their culture, as a rule, ingests much less than say, the U.S., throwing the results of this reasearch off?
And could the weather indeed be a factor, because as noted England lacks the sunshine necessary for the Vitamin D which aids calcium absorption?
Comments
do the British get enough calcium daily, or perhaps their culture, as a rule, ingests much less than say, the U.S.?
<!--QuoteEnd--></div><!--QuoteEEnd-->
Put calcium in beer, problem solved D:
Honestly I think they're controlling for variables like "do the people take calcium or not" or "do they get vitamin D or not."
But seriously, the crap weather we get over here could be a very slight factor, being as the lower levels of vitamin D resulting in less calcium adsorption.
Lower calcium levels would then give a slightly increased risk of <i>general</i> osteoporosis in later life, which would probably be a better area of focus for this study, as just hip fractures are too much of a focused area for a record based study imo. General osteoporosis would be increased if the drugs truely are linked to increased hip fractures, which would be an effect of osteoporosis.
Dunno about any other factors that might be present, but I assume they'd controlled them all.
</b>
There are some groups of the UK population who are more at risk for vitamin D deficiency. These groups may need to introduce some time outside into their daily routine or take dietary supplements to increase their vitamin D levels. They include:
* Elderly people - especially if institutionalised or home bound
* Dark skinned people
* Women with darker skin who wear veils or dress to cover most of their skin
* Some infants – especially if breast fed by a vitamin D deficient mother<!--QuoteEnd--></div><!--QuoteEEnd-->
We already know the average age in the study was 77, so bingo on the first one.
It wasn't specified if there were a large percentage of dark skinned people involved.
I doubt the third point was much of a factor.
We don't know how many of those studied were breast fed by vitamin D deficient mothers.
So... what is the average number of hours of sunshine for the UK and US?
Pads? Brake pads? Pacific Assistance Dogs Society? Principles of Advanced and Distributed Simulation? Launch pads? <img src="http://www.nsmod.org/forums/style_emoticons/default/rolleyes.gif" border="0" alt="IPB Image" />
If you're really interested, go and pick up a copy of that edition of that journal and read it. And the work it references. And then go and take a course in basic scientific principals. Hopefully by then you might've gotten an idea of how naive you are.
--Scythe--
Discussion I have been involved in on this have continually pointed out the vitamin D issue, which directly affects calcium absorption - hence my questioning the sunshine factor.
Naive I may be, but simple facts such as the average age they covered are utterly ridiculous. Hell, old folks who are 77 are already well known for accidental falls resulting in hip fractures.
Discussion I have been involved in on this have continually pointed out the vitamin D issue, which directly affects calcium absorption - hence my questioning the sunshine factor.
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But wouldn't those factors equally effect the people who used the drugs and the people who didn't? That's kinda the idea behind a study like this, having two groups who differ in only one (hopefully) significant way, then seeing if you get different results. And there seemed to be some different results from the study.
Depot, apparently you slept through all your science classes, because when there's a variable like Vitamin D intake that would effect the experiment, they control it. In this case they'd make sure nobody ran around with Vitamin D deficiency because that would invalidate the results.
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If you can find in the JAMA's report where vitamin D was controlled please let us know.
<!--sizeo:1--><span style="font-size:8pt;line-height:100%"><!--/sizeo-->And kindly give me credit for already looking.<!--sizec--></span><!--/sizec-->
<b>OSTEOPOROSIS</b>
A disease affecting the bone structure of people, most notably elderly, but affecting potentially all age groups. The main modifiable factors of which are (amongst a couple of others) Vitamin D deficiency, and calium intake deficiency.
Repeat after me.
<b>OSTEOPOROSIS</b>
A disease affecting the bone structure of people, most notably elderly, but affecting potentially all age groups. The main modifiable factors of which are (amongst a couple of others) Vitamin D deficiency, and calium intake deficiency.
<!--QuoteEnd--></div><!--QuoteEEnd-->
My point exactly, given the average age was 77.
I still don't understand your fascination with the fact that they're 77. Are you really this dense?
77 year olds are prone to hip failure, yes. But that's what CONTROL groups are for. Do you understand the concept? This isn't a "it's my opinion, I'm free to be a skeptic" thing. Either come up with a logical argument as to why the study is flawed, or... well, I'm sure you can guess what the alternative suggestion might be.
Well feel free to provide your counter-study, or at least a compelling argument against this study.
77 year olds are prone to hip failure, yes. But that's what CONTROL groups are for. Do you understand the concept? This isn't a "it's my opinion, I'm free to be a skeptic" thing. Either come up with a logical argument as to why the study is flawed, or... well, I'm sure you can guess what the alternative suggestion might be.
<!--QuoteEnd--></div><!--QuoteEEnd-->
One point already made was the failure of the study to disclose dietary guidelines. Without that it's difficult to assess.
Just because 145,000 Brits participated in this study and it was published in the JAMA doesn't mean it's without fault.
One point already made was the failure of the study to disclose dietary guidelines. Without that it's difficult to assess.
Just because 145,000 Brits participated in this study and it was published in the JAMA doesn't mean it's without fault.
<!--QuoteEnd--></div><!--QuoteEEnd-->
What's that going off? I don't have a subscription to JAMA so I can't access the study in full, just the abstract and the news article, which means approx. nothing.
Variation due to dietary habits would have also been removed by the sheer size of the study. Increase the volume size, decrease the effects of the variables...
HAHAHAHA LOGIC, WHO NEEDS IT!! HAHAHA WOW I LOVE BEING DUMB
They're comparing people taking the drugs with people not taking the drugs, not people with different backgrounds. Evidently, they're not comparing new-born Ethiopian girls with elderly American men. Rather, they're comparing old British people taking the drugs, with old British people not taking the drugs. That would make sense and would prove that the drugs DO have an effect.
<!--QuoteEnd--></div><!--QuoteEEnd-->
You don't understand -- they're old, it's their time. Studies like this are a waste of time! They're OLD! OLD!!!
</incredible sarcasm>
They're comparing people taking the drugs with people not taking the drugs, not people with different backgrounds. Evidently, they're not comparing new-born Ethiopian girls with elderly American men. Rather, they're comparing old British people taking the drugs, with old British people not taking the drugs. That would make sense and would prove that the drugs DO have an effect.
<!--QuoteEnd--></div><!--QuoteEEnd-->
but they're not reporting on anything else. the study is *at most* an interesting statistic that warrants investigation.
They're comparing people taking the drugs with people not taking the drugs, not people with different backgrounds. Evidently, they're not comparing new-born Ethiopian girls with elderly American men. Rather, they're comparing old British people taking the drugs, with old British people not taking the drugs. That would make sense and would prove that the drugs DO have an effect.
<!--QuoteEnd--></div><!--QuoteEEnd-->
Since medical records fail to contain dietary or vitamin D intake, and would also not include the amount of exposure to sunshine, I'll agree with Black Mage. Totally.
<!--quoteo(post=1594775:date=Jan 4 2007, 07:36 AM:name=Black_Mage)--><div class='quotetop'>QUOTE(Black_Mage @ Jan 4 2007, 07:36 AM) [snapback]1594775[/snapback]</div><div class='quotemain'><!--quotec-->
but they're not reporting on anything else. the study is *at most* an interesting statistic that warrants investigation.
<!--QuoteEnd--></div><!--QuoteEEnd-->
I'll agree with Black Mage. Totally.
<!--QuoteEnd--></div><!--QuoteEEnd-->
In other news: Record lows reported from Hades. Story at eleven.