2013 CAG立场声明：质子泵抑制剂治疗与髋骨骨折.docx

CAG Position Statement:Hip fracture and proton pump inhibitor therapy – a 2013 updateCAG的立场声明：髋部骨折和质子泵抑制剂治疗- 2013年更新Health Canada have recently provided an information update on proton pump inhibitor (PPI) therapyand risk of fracture in April 2013 (1) stating “Several scientific studies suggest that PPI therapy may beassociated with a small increased risk for fractures of the hip, wrist, or spine related to osteoporosis, adisease resulting in the weakening of bones. The risk of fracture was higher in patients who receivedmultiple daily doses of PPIs and therapy for a year or longer. Additional risk factors forosteoporosis,such as age, gender and the presence of other health conditions, may also contribute to the increasedrisk of fractures. At Health Canada’s request, manufacturers of all PPIs marketed in Canada haveupdated the drug labels for their products to include information on this risk.”加拿大卫生部最近提供了一个质子泵抑制剂（PPI）治疗的信息更新，在2013年4月的骨折风险（1）说明“一些科学研究表明，PPI治疗可能是一个小的风险增加髋部、腕部骨折，或脊柱相关疾病的骨质疏松症，导致骨骼弱化。骨折风险较高的患者接受PPI治疗多每天服用一年或更长时间。骨质疏松症的其他危险因素，如年龄，性别和其他健康状况的存在，也有助于增加骨折的风险。在加拿大卫生部的要求，所有在加拿大销售的厂家有PPIs更新他们的产品包括信息风险的药物标签。”The Canadian Association of Gastroenterology provided a position statement on PPI therapy and risk ofhip fracture in 2008 (2) and we have updated this in light of the recent Health Canada statement. Largeadministrative databases are a useful tool to assess possible benefit or harms of health careinterventions but given that billions of associations can be measured with these databases then highlystatistically significant findings will inevitably occur by chance. Added to this problem is that anyassociation may simply be due to confounding factors and not due to the health care interventioncausing the disease (e.g. a database study may find that steroid inhaler therapy increases the risk of lungcancer but this may simply due to smokers are more likely to have lung disease (and be given steroidinhalers) and smoking causes lung cancer). Associations between