PPIs Might Decrease the Effectiveness of Alendronate to Prevent Fractures

Alendronate, a bisphosphonate, is frequently used to prevent osteoporotic fractures in elders. Proton-pump inhibitors (PPIs) are also commonly prescribed in this population, sometimes to treat gastrointestinal symptoms from the bisphosphonate. Some studies suggest that PPIs decrease absorption of bisphosphonates, calcium, and vitamin B₁₂; others imply a direct association between PPIs and risk for hip fracture, but findings have been mixed (JW Gastroenterol May 21 2010).

To address the potential impact of PPI use on the efficacy of alendronate, investigators used national databases from Denmark to identify 38,088 new users of alendronate during a 10-year period. Researchers followed these patients for a mean of 3.5 years, monitoring their al…