Medicijnen tegen brandend maagzuur verhogen kans op botbreuken.*
Uit een grote studie uitgevoerd onder 145.000 Britten van 50 jaar en ouder, blijkt dat de gangbare medicijnen tegen brandend maagzuur de kans op het breken van een heup flink kunnen vergroten. Gebruik je langer dan een jaar zulke medicijnen dan heb je 44% meer kans op een breuk dan iemand die deze medicijnen niet gebruikt. Gebruik je ook nog eens langer dan een jaar een hoge dosis dan is de kans wel 250% hoger. De effecten bleken vooral voor mannen te gelden wellicht omdat oudere vrouwen vaker al bijv. extra calcium nemen tegen botontkalking.
Common
Heartburn Drugs Linked to Hip Fracture
Taking
such popular heartburn drugs as Nexium, Prevacid or Prilosec for a year or more
can raise the risk of a broken hip markedly in people over 50, a large study in
Britain found.
The
study raises questions about the safety of some of the most widely used and
heavily promoted prescription drugs on the market, taken by millions of people.
The
researchers speculated that when the drugs reduce acid in the stomach, they also
make it more difficult for the body to absorb bone-building calcium. That can
lead to weaker bones and fractures.
Hip
fractures in the elderly often lead to life-threatening complications. As a
result, doctors should make sure patients have good reason to stay on heartburn
drugs long term, said study co-author Dr. Yu-Xiao Yang of the University of
Pennsylvania School of Medicine.
"The
general perception is they are relatively harmless," Yang said. "They
often are used without a clear or justified indication for the treatment."
Some
people find relief from heartburn with over-the-counter antacids such as Tums,
Rolaids and Maalox. But for others, those medicines do not work well. Moreover,
heartburn can be more than a source of discomfort. People with chronic heartburn
can develop painful ulcers in the esophagus, and in rare cases, some can end up
with damage that can lead to esophageal cancer.
Dr.
Sandra Dial of McGill University in Montreal, who was not involved in the study
but has done similar research, said patients should discuss the risks and
benefits with their doctors and taper off their use of these medicines if they
can.
Nexium,
Prevacid and Prilosec are members of a class of drugs known as proton pump
inhibitors. The study found a similar but smaller risk of hip fractures for
another class of acid-fighting drugs called H2 blockers. Those drugs include
Tagamet and Pepcid.
The
study, published in Wednesday's Journal of the American Medical Association,
looked at medical records of more than 145,000 patients in England, where a
large electronic database of records is available for research. The average age
of the patients was 77.
The
patients who used proton pump inhibitors for more than a year had a 44 percent
higher risk of hip fracture than nonusers. The longer the patients took the
drugs, the higher their risk.
The
biggest risk was seen in people who took high doses of the drugs for more than a
year. That group had a 21/2 times greater risk of hip fractures than nonusers.
Yang
said that for every 1,262 elderly patients treated with the drugs for more than
a year, there would be one additional hip fracture a year attributable to the
drugs. For every 336 elderly patients treated for more than a year with high
doses, there would be one extra hip fracture a year attributable to the drugs.
Dr.
Doug Levine of AstraZeneca PLC, which makes Nexium and Prilosec, said the study
does not prove that proton pump inhibitors cause hip fractures. It merely
suggests a potential association, he said. Doctors need to monitor their
patients for proper dosage and watch how long they take the drugs, Levine said.
Julia
Ellwanger, a spokeswoman for TAP Pharmaceutical Products Inc., which markets
Prevacid, said proton pump inhibitors' safety has been well-established by
rigorous studies, and the new study does not prove or disprove a connection to
hip fractures.
Dr.
Alan Buchman of Northwestern University, who was not involved in the research,
said the study should not change medical practice, since doctors already should
be monitoring the bone density of elderly people taking the drugs and
recommending calcium-rich diets to all patients.
"Most
people are not taking enough calcium to start with," he said. He also
wondered if a similar result would have been found in a sunny climate, because
vitamin D from sunshine helps with calcium absorption.
Also,
Buchman said it is not known whether the acid-fighting drugs prevent esophageal
cancer. He said the risk of esophageal cancer has been exaggerated in the
marketing of these drugs.
"I
think the risk has been overplayed and scared the community," Buchman said.
Heartburn
medicines are heavily advertised in "Ask your doctor about ..."
commercials in the U.S., particularly during the evening news.
Nexium
is the second biggest selling drug in the world, behind the cholesterol medicine
Lipitor, with global sales totaling $4.6 billion last year, according to IMS
Health, which tracks drug sales.
Yang
and his co-authors disclosed in the paper that they have worked as consultants
and received speaking fees from companies making acid-fighting drugs. The study
was funded by the National Institutes of Health and the American
Gastroenterological Association/GlaxoSmithKline Glaxo Institute for Digestive
Health.
Men
in the study had a higher drug-associated risk of hip fracture than women,
possibly because women may be more aware of osteoporosis and may get more
calcium in their diets, Yang said. He plans more research on whether
calcium-rich diets or calcium supplements can prevent the problem.
(Jan. 2007) (Opm. Een goede voedingsgewoonte, met gezonde voeding en rustig eten maakt de kans op brandend maagzuur al heel klein. Er zijn wetenschappers die zeggen dat brandend maagzuur een gevolg is van veel te weinig water drinken waardoor het lichaam begint te dehydrateren, dus drink genoeg water. Als u gaat liggen terwijl u last heeft van brandend maagzuur ga dan op uw linkerzijde liggen, waardoor een gasbel de doorgang naar de slokdarm afsluit. Nog een paar tips bij brandend maagzuur)