Editing Proton-pump inhibitor (section)

===Bone ===
High dose or long-term use of PPIs carries an increased risk of [[bone fracture]]s which was not found with short-term, low dose use; the FDA included a warning regarding this on PPI drug labels in 2010.<ref name="fda">{{cite web |url=https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fda-drug-safety-communication-possible-increased-risk-fractures-hip-wrist-and-spine-use-proton-pump |title=FDA Drug Safety Communication: Possible increased risk of fractures of the hip, wrist, and spine with the use of proton pump inhibitors |date=23 March 2011 |publisher=U.S. [[Food and Drug Administration]] (FDA) |access-date=23 August 2015}}</ref>

In infants, acid suppression therapy is frequently prescribed to treat symptomatic gastroesophageal reflux in otherwise healthy infants (that is: without [[gastroesophageal reflux disease]]). A study from 2019 showed that  PPI use alone and together with histamine H2-receptor antagonists was associated with an increased bone fracture hazard, which was amplified by days of use and earlier initiation of therapy.<ref name="ped">{{cite journal |last1=Malchodi |first1=Laura |last2=Wagner |first2=Kari |last3=Susi |first3=Apryl |last4=Gorman |first4=Gregory |last5=Hisle-Gorman |first5=Elizabeth |date=July 2019 |title=Early Acid Suppression Therapy Exposure and Fracture in Young Children |journal=Pediatrics |volume=144 |issue=1 |pages=e20182625 |doi=10.1542/peds.2018-2625 |issn=1098-4275 |pmid=31175146|s2cid=182948146 |doi-access=free }}</ref> The reason is not clear; increased bone break down by [[osteoclast]]s has been suggested.<ref>{{cite journal |last1=Nehra |first1=Avinash K. |last2=Alexander |first2=Jeffrey A. |last3=Loftus |first3=Conor G. |last4=Nehra |first4=Vandana |date=2018 |title=Proton Pump Inhibitors: Review of Emerging Concerns |journal=Mayo Clinic Proceedings |language=en |volume=93 |issue=2 |pages=240–246 |doi=10.1016/j.mayocp.2017.10.022|pmid=29406201 |s2cid=20212012 |doi-access=free }}</ref>

A recent 2024 study published in the ''Journal of Clinical Endocrinology & Metabolism'' found that chronic use of PPIs in men is linked to lower trabecular bone quality.<ref>{{Cite web |date=2024-09-25 |title=Chronic PPI Use Affects Bone Quality Among Men |url=https://www.endocrinologyadvisor.com/news/chronic-ppi-use-affects-bone-quality/ |access-date=2024-09-29 |website=Endocrinology Advisor |language=en-US}}</ref> Specifically, PPI use was associated with reduced lumbar spine trabecular bone score (TBS), as well as lower bone mineral density (BMD) T-scores in the lumbar spine, total hip, and femoral neck.<ref>{{Cite journal |last1=Bioletto |first1=Fabio |last2=Pusterla |first2=Alessia |last3=Fraire |first3=Federica |last4=Sauro |first4=Lorenzo |last5=Presti |first5=Michela |last6=Arvat |first6=Emanuela |last7=Ghigo |first7=Ezio |last8=Procopio |first8=Massimo |last9=Barale |first9=Marco |date=2024-08-28 |title=Sex-specific Association of Chronic Proton Pump Inhibitor Use With Reduced Bone Density and Quality |url=https://academic.oup.com/jcem/advance-article-abstract/doi/10.1210/clinem/dgae598/7743296?redirectedFrom=fulltext |journal=The Journal of Clinical Endocrinology & Metabolism |pages=dgae598 |doi=10.1210/clinem/dgae598 |pmid=39197024 |issn=0021-972X|doi-access=free }}