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국민건강보험 12년 표본코호트자료를 이용한 프로톤펌프억제제 사용과 골절 위험의 연관성

Association of Proton Pump Inhibitor Use and Risk of Fracture Based on the National Health Insurance Sample Cohort Database (2002~2013)

한국임상약학회지 2019년 29권 3호 p.147 ~ 155
김종주 ( Kim Jong-Joo ) - 차의과학대학교 약료정보연구원

 ( Jang Eun-Jin ) - 안동대학교 자연과학대학
조준우 ( Cho Jun-Woo ) - 경북대학교 자연과학대학
손현순 ( Sohn Hyun-Soon ) - 차의과학대학교 약학대학


Objectives: The purpose of this study was to investigate the association between fracture risk and proton pump inhibitor (PPI) use to establish evidence for defining high-risk groups of fracture among PPI users.

Methods: A case-control study was performed using the National Health Insurance Sample Cohort Database from January 2002 to December 2013. The cases included all incidences of major fractures identified from January 2011 to December 2013, and up to four controls were matched to each case by age, gender, osteoporosis, and Charlson comorbidity index. Conditional logistic regression was used to calculate the adjusted odds ratio (aOR) and associated 95% confidence interval (CI).

Results: Overall, 14,295 cases were identified, and 63,435 controls were matched to the cases. The aOR of fractures related to the use of PPIs was 1.06 (95% CI: 1.01-1.11). There was a statistically significant association between fracture and PPI use within 3 months of the last dose, and a trend of increasing fracture risk with increasing cumulative PPI dose. The risk of fracture was significantly higher in patients who took PPIs for more than 1 year during the 2-year observation period.

Conclusion: Patients who have been using PPIs for more than 1 year should be warned about the risk of fracture during or at least 3 months after discontinuing the PPI.


Proton pump inhibitor; fracture; case-control; National Health Insurance Sample Cohort Database; population based
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