Anew analysis adds to growing evidence that people using proton pump inhibitors to control symptoms of acid reflux are more likely to fracture bones than those who do not. The analysis did not find a similar increase in fracture risk among patients taking older acid reflux medications, called histamine-2 receptor antagonists. Last year, the Food and Drug Administration revised the label on proton pump inhibitors, or P.P.I.'s, to warn that they may raise the risk of fractures. In March, it removed the warnings from non-prescription P.P.I.'s, saying those were meant only for short courses of treatment while the fracture risk had been observed in long-term users.

The new analysis, published in the May-June issue ofAnnals of Family Medicine, examined 11 studies and found that patients taking P.P.I.'s were 29 percent more likely to get fractures.