HealthDay News – Proton pump inhibitor (PPI) use in children is associated with a small but significant increased risk for any fracture, according to a study published online March 16 in JAMA Pediatrics.

Yun-Han Wang, from the Karolinska Institutet in Stockholm, and colleagues used data from a nationwide register to evaluate the association between PPI use and risk for fracture in children. The analysis included 115,933 children initiating PPI use (July 2006 to December 2016) and 115,933 age- and propensity score-matched children not using PPIs.

The researchers found that during a mean of 2.2 years of follow-up, 5354 cases of any fracture occurred among children who initiated PPIs vs 4568 among those who did not (20.2 vs 18.3 events per 1000 person-years; hazard ratio [HR], 1.11; 95% CI, 1.06 to 1.15). Elevated risk for fracture with PPIs was seen for upper-limb (HR, 1.08; 95% CI, 1.03 to 1.13), lower-limb (HR, 1.19; 95% CI, 1.10 to 1.29), and other fractures (HR, 1.51; 95% CI, 1.16 to 1.97). However, there was no association between PPI use and head fracture (HR, 0.93; 95% CI, 0.76 to 1.13) or spine fracture (HR, 1.31; 95% CI, 0.95 to 1.81). Risk for fracture increased with cumulative duration of PPI (HRs, 1.08 for 30 days or less [95% CI, 1.03 to 1.13]; 1.14 for 31 to 364 days [95% CI, 1.09 to 1.20]; and 1.34 for 365 days or more [95% CI, 1.13 to 1.58]).

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“These data suggest that PPI use is associated with a small increased risk of fracture in children; the findings inform safety considerations when these drugs are prescribed to pediatric patients,” the authors write.

One author disclosed financial ties to Celgene and IQVIA.

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