Project 176317

Proton pump inhibitors (PPIs) are among the most commonly prescribed medications in clinical practice. PPIs are the most effective medications for reducing the production of stomach acid, and as a result are very effective for the treatment and prevention of upper gastrointestinal diseases, including gastroesophageal reflux (GERD) and peptic ulcer disease. These medications are generally believed to be safe, though recent studies have suggested that the use of these medications is associated with the development of osteoporosis related fractures, including those of the hip, spine, and wrist. However it is unclear whether the relationship between PPIs and osteoporosis-related fractures is causative, nor has the mechanism by which PPIs may promote osteoporosis or fractures been elucidated. PPIs are commonly used in the elderly, who are at the highest risk of developing osteoporosis and osteoporosis related fractures. Furthermore, osteoporosis related fractures, especially hip fractures, are associated with a high risk of death and disability, with up to 20% of people diagnosed with a hip fracture dying within six months, and a high proportion of survivors left with significant disability and loss of independence. Our determining that PPIs definitively contribute to the risk of osteoporosis and osteoporosis related fractures may therefore have a huge impact on patient care. Therefore, we are seeking to perform a number of related studies in man and in animal models with the aim of providing further information on the possible cause-and-effect relationship between PPIs, osteoporosis, and osteoporosis related fractures.