Association Between Proton Pump Inhibitor Use and Risk of Fr
Proton pump inhibitor (PPI) use has been linked to increased risk of fracture in adults. Despite a trend in the prescription of PPIs in children, there is scarce evidence regarding this safety concern in pediatric patients. The aim of this study was To evaluate the association between PPI use and the risk of fracture in children. Children younger than 18 years who initiated PPI use were matched on propensity score and age with those who did not initiate PPI use.

Cox regression was adopted to estimate hazard ratios (HRs) for the first fracture of any type and 5 subtypes of fracture, with follow-up for up to 5 years. To address potential residual confounding, high-dimensional propensity score matching and a direct comparison with histamine-2 receptor antagonists were performed.

There were a total of 115 933 pairs of children who initiated PPI use with 115 933 matched individuals who did not initiate use and found that PPI use was associated with an 11% increased risk of fracture, a significant difference.

Conclusions and Relevance
In this large pediatric cohort, PPI use was associated with a small but significant increased risk of any fracture. Risk of fracture should be taken into account when weighing the benefits and risks of PPI treatment in children.

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