PMID- 35112645
OWN - NLM
STAT- MEDLINE
DCOM- 20220401
LR  - 20220531
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 38
IP  - 4
DP  - 2022 Apr
TI  - A multicenter cohort analysis of fractures in histamine-2-receptor antagonist 
      treated pediatric patients.
PG  - 565-570
LID - 10.1080/03007995.2022.2037847 [doi]
AB  - BACKGROUND: Histamine 2 receptor antagonists (H2RA) are amongst the most 
      entrenched antacid therapies available including over-the-counter. They have an 
      excellent safety profile including no known teratogenic risk. Fracture risk is 
      generally recognized with chronic proton pump inhibitor (PPI) therapy in adults 
      and children although the related mechanism is poorly understood. The analogous 
      risk in H2RAs, including in children, is unclear. We studied the fracture risk 
      and characteristics among hospitalized pediatric patients exposed to H2RA 
      compared to an untreated cohort. METHODS: The Pediatric Health Information System 
      (PHIS) multicenter database was queried for hospital encounters of children aged 
      6 months - 15.5 years and between 7/2016 and 8/2017. Patients with comorbidities 
      and medications including PPI that predispose for fractures were excluded from 
      the cohort and a propensity-matched control was identified. The subjects and 
      controls were followed for 2 years for hospitalization with fracture diagnoses. 
      RESULTS: Our cohort included 3526 patients with exposure to H2RA and matched 
      controls. Fractures were reported in 1% of patients (67) with no statistical 
      difference between the groups. Upper, then lower extremity fractures were the 
      most common in both groups. Axial skeleton fractures were the least frequently 
      encountered fractures among both groups. CONCLUSION: H2RA exposure is not 
      associated with an increased risk of fracture in hospitalized children exposed to 
      H2RA when compared with a matched untreated cohort, further studies are needed to 
      determine if long-term exposure to H2RA may be associated with fracture risk in 
      both those with and without comorbidities or on fracture predisposing medication.
FAU - Fleishman, Nathan R
AU  - Fleishman NR
AD  - Department of Gastroenterology, Levine Children's Hospital, Charlotte, North 
      Carolina, USA.
FAU - Richardson, Troy
AU  - Richardson T
AD  - Children's Hospital Association, Lenexa, Kansas, USA.
FAU - Attard, Thomas M
AU  - Attard TM
AUID- ORCID: 0000-0002-7480-4437
AD  - Department of Gastroenterology, Children's Mercy Hospitals and Clinics, Kansas 
      City, Missouri, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20220225
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Histamine H2 Antagonists)
RN  - 820484N8I3 (Histamine)
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Fractures, Bone/chemically induced
MH  - *Histamine
MH  - *Histamine H2 Antagonists/adverse effects
MH  - Humans
MH  - Infant
MH  - Retrospective Studies
OAB - PLAIN LANGUAGE SUMMARYWhat is knownHistamine-2-receptor antagonists (H2RA) are 
      amongst the most widely used acid suppression therapy in children.H2RA therapy is 
      regarded as safe in children including infants.Fracture risk associated with 
      proton pump inhibitor (PPI) therapy in children has not been adequately studied 
      in children.What is newThe incidence of fractures in children aged 6 months 
      through 15.5 years followed for 2 years after H2RA therapy was not increased when 
      compared to a matched controlUse of H2RA therapy is safer than PPI therapy with 
      respect to fracture risk in children with no other risk factors.Further studies 
      are needed to assess the association of long-term exposure to H2RA with fracture 
      risk in children without predisposing risk for fracture.
OABL- eng
OTO - NOTNLM
OT  - Adverse effects
OT  - Bone/epidemiology
OT  - Fractures
OT  - Gastroesophageal Reflux/drug therapy
OT  - Histamine H2 Antagonists/therapeutic use
OT  - Retrospective Studies United States/epidemiology
OT  - acid-suppression
OT  - peptic ulcer disease therapy
EDAT- 2022/02/04 06:00
MHDA- 2022/04/02 06:00
CRDT- 2022/02/03 08:39
PHST- 2022/02/04 06:00 [pubmed]
PHST- 2022/04/02 06:00 [medline]
PHST- 2022/02/03 08:39 [entrez]
AID - 10.1080/03007995.2022.2037847 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2022 Apr;38(4):565-570. doi: 10.1080/03007995.2022.2037847. 
      Epub 2022 Feb 25.