Long-term use of proton pump inhibitors and oral anticoagulants may be linked to an increased risk of developing iron deficiency anemia in adult patients.
In the recent case-control study, published in BMJ Open Gastroenterology, investigators examined the association between certain drugs and the development of iron deficiency anemia in 1,210 adult patients—409 of whom had iron deficiency anemia and 801 of whom were controls. They focused on long-term exposure to proton pump inhibitors and oral anticoagulants, using multivariable logistic regression to calculate odds ratios (OR) for iron deficiency anemia associated with various drug classes and adjusting for age, sex, and concurrent drug use.
The investigators discovered that long-term proton pump inhibitor use was associated with an increased risk of iron deficiency anemia (OR = 3.29, 95% confidence interval [CI] = 2.47–4.41, P < .001). Long-term oral anticoagluant use was also significantly associated with iron deficiency anemia (OR = 2.04, 95% CI = 1.29–3.24; P = .002). No significant associations were found with long-term use of antidepressants, antiplatelet agents, or nonsteroidal anti-inflammatory drugs.
The findings indicated that the link between oral anticoagluants and iron deficiency anemia was mainly seen in patients with underlying hemorrhagic lesions in the gastrointestinal tract, which may have been related to chronic blood loss from these lesions. In contrast, the link between proton pump inhibitors and iron deficiency anemia was independent of hemorrhagic lesions, implying different underlying mechanisms.
The authors declared no specific grants for this research from any funding agency in the public, commercial, or not-for-profit sectors.