Proton Pompa İnhibitörlerinin Kırık Oluşumuna Etkisi ve Bakıma Yansıması

Yıl 2021, Cilt: 14 Sayı: 1, 62 - 66, 15.01.2021

Seda Akutay , Özlem Ceyhan

https://doi.org/10.46483/deuhfed.736337

Öz

Proton pompa inhibitörleri (PPİ) gastrointestinal sistem hastalıklarında ve nonsteroidal antiinflamatuar ilaçların gastrointestinal sistem üzerindeki yan etkilerini önlemek amacıyla kullanılan ilaçlardır. Ülkemizde yapılan çalışmalar yıllar içinde proton pompa inhibitörlerinin kullanımındaki artışı gözler önüne sermiştir. Tüm ilaçlarda olduğu gibi proton pompa inhibitörlerinin de kullanımıyla bazı istenmeyen etkiler gelişebilmektedir. Artmış kemik kırığı riski proton pompa inhibitörlerinin uzun dönem kullanımları ile ortaya çıkan yan etkiler arasında yer almaktadır. Proton pompa inhibitörlerinin kemik kırığına yol açma nedenleri ile ilgili pek çok teori ileri sürülmektedir. Son yıllarda yapılan meta-analiz ve sistematik derlemelerden ortaya çıkan sonuçlar kırığa zemin hazırladığını destekler nitelikte olup bir yıldan uzun süreli proton pompa inhibitörü kullananlarda kalça kırığı, vertebra kırığı, bilek ve ön kol kırığının proton pompa inhibitörü kullanmayanlara göre birkaç kat daha fazla olduğu yönündedir. Özellikle yaşlı ve kadınlarda kırık riskinin daha fazla olduğu bildirilmektedir. Bu derleme PPİ kullanımının oluşturduğu riskler açısından dikkat çekmesi ve bakımı planlamada yol gösterici olması amacı ile yazılmıştır.

Anahtar Kelimeler

İlaçla İlişkili Yan Etki, Kırıklar, Proton Pompa İnhibitörleri

The Effect of Proton Pump Inhibitors on Fracture Formation and Reflection on Care

Öz

Proton pump inhibitors (PPI) are used in gastrointestinal system diseases and nonsteroidal anti-inflammatory drugs to prevent side effects of gastrointestinal system. Studies in our country have shown the increase in the use of proton pump inhibitors over the years. As it exists in all drugs, the use of proton pump inhibitors may cause some undesirable effects.These side effects can be considered in two groups as short and long term side effects. Increased risk of bone fracture is one of the side effects associated with the long-term use of proton pump inhibitors. A my riad of theories have been proposed regarding the causes of proton pump inhibitors leading to bone fracture. The results obtained from the meta-analysis and systematic reviews conducted in recent years support that they predispose to the fracture and suggest that hip fractures, vertebral fractures, wrist and forearm fractures are several times higher in those who use proton pump inhibitors for more than one year than those who do not use proton pump inhibitors.It is reported that the risk of fracture is higher especially in elderly and women. This review was written to draw attention to the risks posed by the use of PPI and to guide the planning of care.

Anahtar Kelimeler

Drug related side effect, fractures, proton pump inhibitors

Kaynakça

• 1. Alam G. Proton pump inhibitors: present and future a review. Int J Pharm Res Dev 2012;4:119-131. Available at: http://ijprd.com/April_12_.Issue.html. Accessed Dec 18, 2019
• 2. Modlin IM, Sachs G, Wright N, Kidd M. Edkins and a century of acid suppression. Digestion 2005;72:129-145. https://doi.org/10.1159/000088368
• 3. Uygun A. Uzun süre proton pompa inhibitörleri (PPI) kullanılacaksa, hangi PPI tercih edilmelidir? Nelere dikkat edilmelidir? Güncel Gastroenteroloji 2012;17:46-58. Erişim adresi: http://guncel.tgv.org.tr/journal/46/pdf/100126.pdf. Erişim tarihi 18 Aralık 2019
• 4. Özden A. Proton pompa inhibitörleri ve kullanım güvenirliği. Güncel Gastroenteroloji 2013;17:179-201. Erişim adresi: http://guncel.tgv.org.tr/journal/46/pdf/100126.pdf. Erişim tarihi 18 Aralık 2019
• 5. Bilgener E. Türkiye’de 2006-2011 yıllarında proton pompası inhibitörleri tüketiminin bütçeye etkisi. Ankara Ecz Fak Derg 2018;42:23-31. https://doi.org/10.1501/Eczfak_0000000604
• 6. Hall JE. Sindirim kanalının salgı işlevleri. In: Çağlayan Yeğen B. editor. Guyton ve Hall Tıbbi Fizyoloji, 12th ed. İstanbul, Nobel Tıp Kitabevleri 2013:777-779.
• 7. Özdemir A, Okuroğlu N. Uzun süreli proton pompa inhibitörü kullanımı ve komplikasyonları. Boğaziçi Tıp Derg 2015;2:35-42.
• 8. Scarpignato C, Gatta L, Zullo A, Blandizzi C, for the SIF-AIGO-FIMMG Group. Effective and safe proton pump inhibitor therapy in acid-related diseases-a position paper addressing benefits and potential harms of acid suppression. BMC Medicine 2016;14:179. http://dx.doi.org/10.1186/s12916-016-0718-z
• 9. Ksiadzyna D, Szelag A, Paradowski L. Overuse of proton pump inhibitors. Pol Arch Med Wewn 2015;125:289-298. http://dx.doi.org/10.20452/pamw.2790
• 10. Çelikbilek M, Doğan S, Akyol L, Yücesoy M. Proton pompa inhibitörlerinin yan etkileri. Bozok Tıp Derg 2013;1:49-52.
• 11. Sivri B. Proton pompa inhibitörleri: optimum proton pompa inhibitörü kullanımı nasıl olmalıdır ? İç Hast Derg 2013;20:107-111.
• 12. Kayhan Koçak FÖ, Sahutoğlu S, Gökdemir B, Saraç ZF, Şahin S, Akçiçek SF. Uzun süreli proton pompa inhibitörü kullanımına sekonder gastrik nöroendokrin hiperplazi. Ege Tıp Derg 2018;57:244-246. https://doi.org/10.19161/etd.416055
• 13. FDA Drug Safety Communication: possible increased risk of fractures of the hip, wrist, and spine with the use of proton pump inhibitors FDA. Available at: 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 2017. Accessed Dec 14, 2019
• 14. Zhou B, Huang Y, Li H, Sun W, Liu J. Proton-pump inhibitors and risk of fractures: an update meta-analysis. Osteoporos Int. 2016;27(1):339–47. https://doi.org/10.1007/s00198-015-3365-x
• 15. Nassar Y, Richter S. Proton-pump Inhibitor Use and Fracture Risk: An Updated Systematic Review and Meta-analysis. J Bone Metab. 2018;25(3):141–51. https://doi.org/10.11005/jbm.2018.25.3.141
• 16. Freedberg DE, Haynes K, Denburg MR, et al. Use of proton pump inhibitors is associated with fractures in young adults: a population-based study. Osteoporos Int 2015;26:2501-2507. https://doi.org/10.1007/s00198-015-3168-0
• 17. Lewis JR, Barre D, Zhu K, et al. Long-term proton pump inhibitor therapy and falls and fractures in elderly women: a prospective cohort study. J Bone Miner Res 2014;29:2489-2497. https://doi.org/10.1002/jbmr.2279
• 18. Reyes C, Formiga F, Coderch M, et al. Use of proton pump inhibitors and risk of fragility hip fracture in a Mediterranean region. Bone 2013;52:557-561. https://doi.org/10.1016/j.bone.2012.09.028
• 19. Thong BKS, Ima Nirwana S, Chin KY. Proton pump inhibitors and fracture risk: a review of current evidence and mechanisms involved. Int J Environ Res Public Health 2019;16:1571. https://doi.org/10.3390/ijerph16091571
• 20. Moberg LME, Nilsson PM, Samsioe G, Borgfeldt C. Use of Proton Pump İnhibitors (PPI) and history of earlier fracture are independent risk factors for fracture in postmenopausal women the WHILA study. Maturitas 2014;78:310-315. https://doi.org/10.1016/j.maturitas.2014.05.019
• 21. van der Hoorn MMC, Tett SE, de Vries OJ, Dobson AJ, Peeters GMEEG. The effect of dose and type of proton pump inhibitor use on risk of fractures and osteoporosis treatment in older Australian women: a prospective cohort study. Bone 2015;81:675-682. https://doi.org/10.1016/j.bone.2015.08.024
• 22. Kim JJ, Jang EJ, Park J, Soon H, Id S. Association between proton pump inhibitor use and risk of fracture : A population-based case-control study. PLoS One.2020;15(7):1–13. http://doi.org/10.1371/journal.pone.0235163
• 23. Wang L, Li M, Cao Y, et al. Proton pump inhibitors and the risk for fracture at specific sites: data mining of the FDA adverse event reporting system. Sci Rep 2017;7:1-9. https://doi.org/10.1038/s41598-017-05552-1
• 24. Fusaro M, D’Arrigo G, Pitino A, et al. Increased risk of bone fractures in hemodialysis patients treated with proton pump inhibitors in real world: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). J Bone Miner Res 2019;34:2238-2245. https://doi.org/10.1002/jbmr.3842
• 25. Farina C, Gagliardi S. Selective Inhibition of Osteoclast Vacuolar H+-ATPase. Curr Pharm Des. 2002;8: 2033–48.
• 26. Sahara T, Itoh K, Debari K, Sasaki T. Specific Biological Functions of Vacuolar-Type H+-ATPase and Lysosomal Cysteine Proteinase, Cathepsin K, in Osteoclasts. Anat Rec. 2003;161:152–61. https://doi.org/10.1002/ar.a.10020
• 27. Khalili H, Huang ES, Jacobson BC, Camargo CA, Feskanich D, Chan AT. Use of proton pump inhibitors and risk of hip fracture in relation to dietary and lifestyle factors: a prospective cohort study. BMJ 2012;344:e372. https://doi.org/10.1136/bmj.e372
• 28. Ngamruengphong S, Leontiadis GI, Radhi S, Dentino A, Nugent K. Proton pump inhibitors and risk of fracture: a systematic review and meta-analysis of observational studies. Am J Gastroenterol 2011;106:1209-1218. http://doi.org/10.1038/ajg.2011.113
• 29. Yang SD, Chen Q, Wei HK, Zhang F, Yang DL, Shen Y, et al. Bone fracture and the interaction between bisphosphonates and proton pump inhibitors: A meta-analysis. Int J Clin Exp Med. 2015;8(4):4899–910.
• 30. Kwok CS, Yeong JKY, Loke YK. Meta-analysis: Risk of fractures with acid-suppressing medication. Bone. 2011;48(4):768–76. http://doi.org/10.1016/j.bone.2010.12.015
• 31. Moayyedi P, Eikelboom JW, Bosch J, Connolly SJ, Dyal L, Shestakovska O, et al. Safety of Proton Pump Inhibitors Based on a Large, Multi-Year, Randomized Trial of Patients Receiving Rivaroxaban or Aspirin. Gastroenterology. 2019;157:682–91. http://doi.org/ 10.1053/j.gastro.2019.05.056
• 32. Fossmark R, Martinsen TC, Waldum HL. Adverse Effects of Proton Pump Inhibitors — Evidence and Plausibility. International Journal of Molecular Sciences. 2019;20(5203). http://doi.org/10.3390/ijms20205203
• 33. Yokota T, Matsui H, Matsuura B, Maeyama K, Onji M. Direct effects of proton pump inhibitors on histamine release from rat enterochromaffin-like cells. Eur J Pharmacol 2003;481:233-240. https://doi.org/10.1016/j.ejphar.2003.09.011
• 34. Biosse-Duplan M, Baroukh B, Dy M, De Vernejoul MC, Saffar JL. Histamine promotes osteoclastogenesis through the differential expression of histamine receptors on osteoclasts and osteoblasts. Am J Pathol 2009;174:1426-1434. https://doi.org/10.2353/ajpath.2009.080871
• 35. Gagnemo-Persson R, Samuelsson A, Håkanson R, Persson P. Chicken parathyroid hormone gene expression in response to gastrin, omeprazole, ergocalciferol, and restricted food intake. Calcif Tissue Int 1997;61:210-215. https://doi.org/10.1007/s002239900325
• 36. Hinson AM, Wilkerson BM, Rothman-Fitts I, Riggs AT, Stack BC, Bodenner DL. Hyperparathyroidism associated with long-term proton pump inhibitors independent of concurrent bisphosphonate therapy in elderly adults. J Am Geriatr Soc 2015;63:2070-2073. https://doi.org/10.1111/jgs.13661
• 37. O’Connell MB, Madden DM, Murray AM, Heaney RP, Kerzner LJ. Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial. Am J Med 2005;118:778-781. https://doi.org/10.1016/j.amjmed.2005.02.007
• 38. Yang YX, Lewis JD, Epstein S, Metz DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA 2006;296:2947-2953. https://doi.org/10.1001/jama.296.24.2947
• 39. Sakata I, Tanaka T, Yamazaki M, Tanizaki T, Zheng Z, Sakai T. Gastric estrogen directly induces ghrelin expression and production in the rat stomach. J Endocrinol 2006;190:749-757. https://doi.org/10.1677/joe.1.06808
• 40. Vestergaard P, Rejnmark L, Mosekilde L. Proton pump inhibitors, histamine H2 receptor antagonists, and other antacid medications and the risk of fracture. 2006;79:76-83. https://doi.org/10.1007/s00223-006-0021-7
• 41. Fedida B, Schermann H, Ankory R, et al. Fracture risk of young adults receiving proton-pump inhibitors and H2-receptor antagonists. Int J Clin Pract 2019;73:e13339. https://doi.org/10.1111/ijcp.13339
• 42. Targownik LE, Lix LM, Leung S, Leslie WD. Proton-Pump inhibitor use is not associated with osteoporosis or accelerated bone mineral density loss. Gastroenterology 2010;138:896-904. http://doi.org/10.1053/j.gastro.2009.11.014
• 43. Hoff M, Skovlund E, Skurtveiet S. et al. Proton pump inhibitors and fracture risk. The HUNT study, Norway. Osteoporos Int 2020;31:109-118. https://doi.org/10.1007/s00198-019-05206-0
• 44. Targownik LE, Goertzen AL, Luo Y, Leslie WD. Long-term proton pump inhibitor use is not associated with changes in bone strength and structure. Am J Gastroenterol 2017;112:95-10. https://doi.org/10.1038/ajg.2016.481
• 45. Yüksel S, Ülker S. Kalça Kırıklı Hastalarda Bakımın Değerlendirilmesi : Prospektif Bir Çalışma. JAREN. 2018;4(2):65–74. https://doi.org/10.5222/jaren.2018.065
• 46. Demir SG, Kalkan ND, Taştan S. Ortopedi ve Travmatoloji hemşirelerinin değişen ve gelişen rolü: fraktür liyezon hemşireliği. Gazi Üniversitesi Sağlık Bilim Derg 2018;3:53-62.