Proton pump inhibitor exposure, trabecular bone score, and BMD

a registry-based cohort study

Zarzour, Fatima Conceptualization; Writing - original draft
Schousboe, John T Conceptualization; Writing - review & editing
Binkley, Neil Conceptualization; Writing - review & editing
Hans, Didier Conceptualization; Data curation; Writing - review & editing
Leslie, William D Conceptualization; Data curation; Formal analysis; Methodology; Project administration; Writing - review & editing

Department of Medicine, University of Manitoba, Winnipeg, MB, R2H 2A6, Canada
Park Nicollet Clinic and HealthPartners Institute, HealthPartners, Minneapolis, MN 55416, United States
Division of Health Policy and Management, University of Minnesota, Minneapolis, MN 55455, United States
Department of Medicine, University of Wisconsin, Madison, WI 53707, United States
Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland
Department of Medicine, University of Manitoba, Winnipeg, MB, R2H 2A6, Canada

Corresponding author: William D. Leslie, Department of Medicine (C5121), University of Manitoba, 409 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada ([email protected]).

Received March 08, 2025

Received in revised form April 16, 2025

Accepted May 12, 2025

Revised June 28, 2025

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected]

Journal of Bone & Mineral Research 40(8):p 965-972, August 2025. | DOI: 10.1093/jbmr/zjaf072

Lay Summary

Proton pump inhibitors (PPI) are medications widely used by patients with acid reflux. Long-term PPI may be associated with increased fracture risk but data are inconsistent. We examined the effect of prior PPI use on trabecular bone score (TBS) and BMD from DXA in 60 930 individuals that included 11 340 (18.6%) with PPI use in the prior 12 mo. After controlling for factors that affect TBS and BMD, even prolonged continuous PPI use did not significantly decrease these measurements or lead to more rapid loss over time.