With the high morbidity rate of peptic ulcer disease (PUD) and gastro-esophageal reflux disease (GERD) around the world, currently there is an increase in the use of digestive disease medications. Commonly used medications for the diseases include H2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs). PPIs are known to inhibit acid secretion more effectively compared to H2RAs in terms of their underlying mechanism. In Korea, there is a dramatic increase in the frequency of use of the medication.

Recent studies have indicated that the long-term use of PPIs may have an effect on increasing bone fracture. However, few studies have investigated the risk of bone fracture by long-term use of PPIs in Korea. Accordingly, it is required to examine the association between PPI use and bone fracture using large-scale data collected in clinical settings.

In the present study, we explore the association between PPI use and osteoporotic bone fracture. Specifically, we investigate any use, cumulative use, does, recent use, and regular use of PPIs are associated with an increased risk of bone fracture.