Asociación entre la exposición prolongada a inhibidores de la bomba de protones y la prescripción de medicamentos para el abordaje de la osteoporosis en pacientes adultos asegurados al sistema de salud colombiano

Abstract

Background: In the past years the proton pump inhibitors have raised a paramount interest in the medical literature due to its adverse events; however, available observational studies do not allow to conclude if they are associated with the prescription of drugs to treat osteoporosis. Study Objective: To determine the association between proton pump inhibitors' long-term exposure and the prescription of osteoporosis drug treatment, adjusting by sociodemographic, clinical and pharmacological variables, in adult patients in Colombia between 2013 and 2018. Methods: A quantitative cohort observational study with retrospective recollection of the information. Conditional logistic regression and survival analysis were applied to estimate the association and to determine the time to the event, respectively. Results: The long-term exposure (OR 1.103 CI95% 0.483-2.52) and the exposure to other drugs with potential outcome as osteoporosis (OR 3.724 CI% 0.852-16.28) were not statistically significant (p>0.05); therefore, the final logistic model was adjusted by age (OR 1.06 CI95% 1.03-1.084), comorbidities (OR 3.34 CI95% 1.27-8.81) and sex (OR 12.82 CI95% 3.05-53.94) (p<0.05), in which the risk was greater in women and directly related to the age. The median time to be prescribed with any drug to treat osteoporosis due to proton pump inhibitors' long-term exposure was approximately 22 months (CI95% 0.345-0.683). Conclusions: It was found that the long-term exposure is not associated with the prescription of osteoporosis drug treatment; nonetheless, further studies are needed to ensure the outcome. A responsible formulation of drugs by the medical team is critical, considering risk and benefit for each patient.