Endurance.Net Ridecamp Archives

 Those folks who support the use of Omeprazole during competition 
should be encouraged by the following article from 2002 regarding their 
short and long term safety in humans:
    
      Proton Pump Inhibitors: An Update

BRUCE T. VANDERHOFF, M.D., and RUNDSARAH M. TAHBOUB, M.D.
Grant Medical Center, Columbus, Ohio

"Since their introduction in the late 1980s, proton pump inhibitors have 
demonstrated gastric acid suppression superior to that of histamine 
H2-receptor blockers. Proton pump inhibitors have enabled improved 
treatment of various acid-peptic disorders, including gastroesophageal 
reflux disease, peptic ulcer disease, and nonsteroidal anti-inflammatory 
drug­induced gastropathy./ Proton pump inhibitors have minimal side 
effects and few significant drug interactions, and they are generally 
considered safe for long-term treatment. /The proton pump inhibitors 
omeprazole, lansoprazole, rabeprazole, and the recently approved 
esomeprazole appear to have similar efficacy. (Am Fam Physician 
2002;66:273-80. Copyright© 2002 American Academy of Family Physicians.)"

 Until..........they read this more recent 2006 article regarding 
complications from the use of PPI's:

Study Links Hip Fracture to Proton Pump Inhibitors

"/An increased risk of hip fracture has been linked to the use of proton 
pump inhibitors/, a class of drugs used to treat acid-related conditions 
such as heartburn and GERD (gastroesophageal reflux disease). According 
to study results published in the December 27, 2006 issue of the Journal 
of the American Medical Association, researchers reported that 
/treatment with proton pump inhibitors for more than one year in people 
over 50 years old was associated with a 44 percent increased risk of hip 
fracture. /The risk was 2.6 times higher for longterm users of proton 
pump inhibitors at high doses. Duration and dosage of proton pump 
inhibitor use were both linked to increased hip fracture risk."

 This is why it is so important to proceed cautiously when campaigning 
for the approval of the use of certain drugs in our endurance horses, in 
order to let them compete when they are not really healthy enough to 
withstand the rigors of competition.  Though more studies need to be 
done to study the relationship between the increased incidence of 
fracture and the use of PPI's, it is reasonable to at least assume that 
since horses are mammals, they may experience a similar disruption of 
their calcium absorption/bone metabolism, placing them at increased risk 
as well.

  Incidentally, in humans, after the age of 50, a hip fracture leads to 
death within 6 months in 30-50% of the cases.  That pesky calcium ion is 
the most regulated substance in the body--horse and human. I think it's 
best not to mess with it's proper absorption and utilization, especially 
in the heat of competition. Stay tuned as this issue plays out in future 
studies.
   Bruce Weary

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