Heartburn Drugs Linked To Hip Fractures

Taking Popular Medicine For At Least A Year Can Raise Broken Bone Risk, Study Shows

(CBS/AP)  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. "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. 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 2 1/2 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.

Dr. David Pura of the University of Virginia Medical Center has also studied acid reflux medications. He, too, says the benefits of them still outweigh the risks, CBS News correspondent Michelle Miller reports.

"I will counsel my patients that it is important that they eat a nutritious diet and that they continue to take these medications because they are suffering from symptoms that affect their quality of life," Dr. Pura told CBS News.

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.

[CarrieSund]

I am 31 and I have been taking prolosec or zantac for at least 4 years almost every day. December of 2008 I went to the emergency room with a hip fracture. My doctors were mystified. I wonder if this is why???

[catt42701]

Stop the advertising of medications on TV and in the magizines. The public does not read the small print. Most of them don't even read their instructions that the pharmacy hands out. Many doctors prescribe the popular drugs because they are wooed by the big companies. Just stop advertising and let the doctors choose the medications based on their readings and research. My doctor can pull out journal articles about every medication I take. He doesn't rely on the advertisements and for that I am grateful.

[godofredo29]

Just a reminder...If you're a guy with osteoporosis, your treatment should be different than that of a woman. If your doctor doesn't seem to know that then you need to look for another doctor.

[bluestardad]

medical field, cure something anything you pimps. Prove you are worth the fleecing you have been giving America all these years.

[RedRobin1]

I was put on Nexium this year and then changed to Protonix. I have no choice but to take this medication, for I have a severe case of acid reflux disease, which was first misdiagnosed as asthma.
Still, and although the drugs have begun to give me my life back (that is how sick I was), I have had concerns about these drugs. Despite all the claims on the information that comes with the medications, I began taking calcium and vitamin D supplements along with a multivitamin daily because I have concerns about the real safety of ANY drug they come out with now. In a way, I feel better knowing my first concerns were probably correct concerning deficiencies, but I am also concerned since I am just over 50 and this medication will most likely be long-term. I have tried to do without it, but I cannot breathe after awhile without it. I keep hoping I will no longer have to take it. Maybe some day....

[RedRobin1]

I was put on Nexium this year and then changed to Protonix. I have no choice but to take this medication, for I have a severe case of acid reflux disease, which was first misdiagnosed as asthma.
Still, and although the drugs have begun to give me my life back (that is how sick I was), I have had concerns about these drugs. Despite all the claims on the information that comes with the medications, I began taking calcium and vitamin D supplements along with a multivitamin daily because I have concerns about the real safety of ANY drug they come out with now. In a way, I feel better knowing my first concerns were probably correct concerning deficiencies, but I am also concerned since I am just over 50 and this medication will most likely be long-term. I have tried to do without it, but I cannot breathe after awhile without it. I keep hoping I will no longer have to take it. Maybe some day....

[gladys_over]

RE: "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."
--------
Arnold Schwarzenegger is 59.

I wonder if he was on any of these drugs.

[uceslady]

Ever heard of HCL? (HYDROCHLORIC ACID) If it is true that too little HCL in the stomach has the same symptons as too much HCL then maybe people are being treated for the wrong thing. Maybe doctors should look at what health conditions are caused by not enough HCL. We need to start investigating HCL ourselves. HCL is essential for the assimilation of calcium and other minerals. As we age our bodies makes less HCL. Lots of things on the market today for digestive problems in reality only decrease HCL and add to our digestive troubles. Without enough HCL the body cannot get the nutrients from food needed to prevent starvation of the body of its nutrients which in return helps prevent the advancement of old age and a malfunctioning digestive tract. This can happen at any age. Could it be something this simple could be the answer to so many of our health woes? HCL is nature's antiseptic. Sometimes we have to look for answers to our own health problems the medicial establishment over looks or does not know. We know Americans health is declining but why. The blood does not tell the whole story of our health. The blood has to have the nutrients and pulls them out of the body tissues so where does that leave the body. If we are not getting them from our foods we are doomed. This is just some food for thought.

[joeshields56]

While the Heartburn story is kind of important, I'm curious why this story on illegal immigration is buried so deeply (without option for viewer comments) on CBSNews. Too much pressure from Big Business interests who benefit from cheap illegal labor?


Civil Rights Groups Sue Over Rent Law
Civil rights groups sue Dallas suburb over law banning rentals to illegal immigrants

DALLAS, Dec. 26, 2006
By ANABELLE GARAY Associated Press Writer
--------------------------------------------------------------------------------

"(AP) Two civil rights groups filed a lawsuit Tuesday challenging a new law in a Dallas suburb that outlaws renting apartments to illegal immigrants, alleging the ordinance violates federal law and forces landlords to act as immigration officers.

The American Civil Liberties Union and the Mexican American Legal Defense and Education Fund filed the suit on behalf of residents and landlords in Farmers Branch, just north of Dallas. It is the third lawsuit brought against the city since the ordinance passed in November.
..."

...the ACLU should change their name to M(exican)CLU.

American middle class need John Edwards as President. He's the only one who cares about us.