Seven studies providing eight comparisons (1,166,069 participants) were included: two prospective studies, two retrospective cohort studies, two case-control studies and one nested-case control study.
Proton pump inhibitor therapy was associated with a statistically significant increase in the risk of hip fracture (OR 1.24, 95% CI 1.15 to 1.34, Ι²=44%; eight comparisons).
No evidence of publication bias was found.
Subgroup analyses taking into account the region where the study was conducted and the duration of the study found similar results to the main analysis except for studies with a duration of three to six years, where the result was no longer significant.