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A Proton Pump Inhibitor's Effect on Bone Metabolism Mediated by Osteoclast Action in Old Age: A Prospective Randomized Study.


ABSTRACT: Proton pump inhibitors (PPIs) act by irreversibly binding to the H(+)-K(+)-ATPase of the proton pump in parietal cells and may possibly affect the vacuolar H(+)-ATPase in osteoclasts.We investigated the effect of 8 weeks of PPI treatment on the parameters of bone turnover and compared PPI with revaprazan, which acts by reversibly binding to H(+)-K(+)-ATPase in proton pumps. This study was a parallel randomized controlled trial. For 8 weeks, either a PPI or revaprazan was randomly assigned to patients with gastric ulcers. The parameters of bone turnover were measured at the beginning of and after the 8-week treatment period.Twenty-six patients (PPI, n=13; revaprazan, n=13) completed the intention-to-treat analysis. After the 8-week treatment period, serum calcium and urine deoxypyridinoline (DPD) were increased in the PPI group (serum calcium, p=0.046; urine DPD, p=0.046) but not in the revaprazan group. According to multivariate linear regression analysis, age ?60 years was an independent predictor for the changes in serum calcium and urine DPD.In elderly patients, administering a PPI for 8 weeks altered bone parameters. Our study suggested that PPIs might directly alter bone metabolism via the vacuolar H(+)-ATPase in osteoclasts.

SUBMITTER: Jo Y 

PROVIDER: S-EPMC4562777 | BioStudies | 2015-01-01T00:00:00Z

REPOSITORIES: biostudies

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