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According to a new study released on June 7, 2007, infants with antacids in their first year of life are more likely to break a bone later. Pediatrics.
The study, "Exposure and fracture related to acid suppression treatment in young children", was led by researchers from the University of Health Sciences uniformed services (USU), in collaboration with the Walter Reed National Military Medical Center (WRNMMC). The researchers sought to determine whether there could be an badociation between acid inhibitors and the risk of bone fracture in children, as this has not been studied extensively in this population , although recent studies have shown such risks in adults, explained Dr. Elizabeth Hisle. -Gorman, corresponding author of the study and Associate Professor of Pediatrics at the USU.
Researchers have investigated the use of two commonly prescribed antacids: proton pump inhibitors or PPIs and H2 or H histamine antagonists.2PRs, which reduce the amount of acid produced by the cells of the lining of the stomach. These drugs are commonly prescribed to adults to treat acid reflux, and have not been shown to cause immediate side effects. After use in adults, PPI and H2RAs were increasingly prescribed in infants to treat normal newborn behaviors such as sputum and colic, and these common symptoms may also be seen in the more severe and rare case of gastroesophageal reflux disease (GERD). GERD is distinguished by its badociation with insufficient weight gain or low weight loss and by the discovery of an inflamed esophagus.
Researchers retrospectively badyzed the health records of more than one million children born in the military health system between 2001 and 2013, looking only at those who were supported by the MHS for at least two years and up to 14 years old. They did not include people already at risk of fracture due to prolonged hospitalization at birth, child abuse, or genetic problems affecting bone health.
Of the 851,631 infants included in the study, 11% (97,286) received antacid before the age of one year. 73% (71,578) of these babies were prescribed H2RA, 9% (7,998) were prescribed a PPI and 18% (17,710), an2PR and a PPI before the age of one year. When one gives only one drug or the other – a PPI or H2PR – medications were taken on average about 60 days at a time. When both drugs were administered together, they were taken for an average of 192 days.
In the end, infants who received only H2RA did not necessarily present an increased risk of bone fractures during childhood. However, infants who received a PPI before the age of one year were 23% more likely to fracture a bone later in childhood, and those who received both PPI and H2RA was 31% more likely. Their risk also seemed to increase, infants were previously prescribed an acid inhibitor (that is, 0 to 6 months) and the longer they took the drug.
Although researchers can not say for sure why there seems to be a link between bone health and these medications in children, they cite the research of other researchers who suggest that it has something to do with these drugs that impede functioning of bone cells called osteoclasts. These cells are important for the maintenance and repair of bones and have an important proton pump that would be stopped by anti-PPI drugs. When osteoclasts can no longer function, the old bone does not break down and the new bone is built on an older, more fragile bone, which weakens the bone. This could be particularly important in young children whose bones are growing rapidly.
The researchers cautioned that more research is needed and that these drugs should be used judiciously in children, taking into account possible risks.
Although this study focuses on the use of PPIs and H2CS in very young children, this allows us to better understand the impact of these drugs on bone health. These results are significant for MHS and the general population, as they help pediatricians, family physicians and other practitioners who care for young children make the best decisions that are important to the health and well-being of their children. children related to the army. Acid suppression medications are among the most commonly prescribed medications in the age group of children. With nearly 1.3 million children in care in the MHS, changes in practices can have a significant impact on children's health. What is even more relevant for the country is that the current generation of children will include the active military force of tomorrow, especially children in the care of the MHS, who will represent 10 to 25 percent of this force. . Having healthy bones is important for their shape and resistance to the physical rigors of military service. "
Dr. Elizabeth Hisle-Gorman
Source:
Uniformed Services University of Health Sciences (USU)
Journal reference:
Hisle-Gorman, E. et al. (2019) Exposure and fracture in young children undergoing treatment for acid suppression. pediatrics. doi.org/10.1542/peds.2018-2625.
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