Role of prescribed medication in the development of iron deficiency anaemia in adults—a case–control study
Objective To estimate the strength of association between exposure to selected classes of prescribed medications and the risk of developing iron deficiency anaemia (IDA), specifically considering oral anticoagulants (OACs), antidepressants, antiplatelet agents, proton pump inhibitors (PPIs) and non-...
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| Language: | English |
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BMJ Publishing Group
2024-06-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/11/1/e001305.full |
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| author | Orouba Almilaji Jonathon Snook Kiran Prabhu Elizabeth Williams Frazer Warricker |
| author_facet | Orouba Almilaji Jonathon Snook Kiran Prabhu Elizabeth Williams Frazer Warricker |
| author_sort | Orouba Almilaji |
| collection | DOAJ |
| description | Objective To estimate the strength of association between exposure to selected classes of prescribed medications and the risk of developing iron deficiency anaemia (IDA), specifically considering oral anticoagulants (OACs), antidepressants, antiplatelet agents, proton pump inhibitors (PPIs) and non-steroidal anti-inflammatories.Design A case–control study involving the analysis of community repeat prescriptions among subjects referred with IDA, and unmatched controls referred as gastroenterology fast-tracks for other indications. Multivariable logistic regression modelling was used to calculate ORs for the association between IDA presentation and each medication class, adjusted for age, sex and coprescribing. For those classes showing significance, it was also used to calculate risk differences between those in the IDA group with or without haemorrhagic lesions on investigation.Results A total of 1210 cases were analysed—409 in the IDA group, and 801 in the control group. Significant associations were identified between presentation with IDA and long-term exposure to PPIs (OR 3.29, 95% CI: 2.47 to 4.41, p<0.001) and to OACs (OR 2.04, 95% CI: 1.29 to 3.24, p=0.002). IDA was not associated with long-term exposure to any of the other three drug classes. In contrast to the relationship with PPIs, the association with OACs was primarily in the IDA sub-group with haemorrhagic lesions.Conclusion Long-term exposure to PPIs and OACs are independently associated with the risk of developing IDA. There are grounds for considering that these associations may be causal, though the underlying mechanisms probably differ. |
| format | Article |
| id | doaj-art-9587bea603f8420b9687787d22afba61 |
| institution | Kabale University |
| issn | 2054-4774 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj-art-9587bea603f8420b9687787d22afba612025-02-12T08:10:10ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742024-06-0111110.1136/bmjgast-2023-001305Role of prescribed medication in the development of iron deficiency anaemia in adults—a case–control studyOrouba Almilaji0Jonathon Snook1Kiran Prabhu2Elizabeth Williams3Frazer Warricker4Department of Health Service Research and Policy, London School of Hygiene & Tropical Medicine, London, UKPoole Hospital NHS Foundation Trust, Poole, UKPoole Hospital NHS Foundation Trust, Poole, UKPoole Hospital NHS Foundation Trust, Poole, UKPoole Hospital NHS Foundation Trust, Poole, UKObjective To estimate the strength of association between exposure to selected classes of prescribed medications and the risk of developing iron deficiency anaemia (IDA), specifically considering oral anticoagulants (OACs), antidepressants, antiplatelet agents, proton pump inhibitors (PPIs) and non-steroidal anti-inflammatories.Design A case–control study involving the analysis of community repeat prescriptions among subjects referred with IDA, and unmatched controls referred as gastroenterology fast-tracks for other indications. Multivariable logistic regression modelling was used to calculate ORs for the association between IDA presentation and each medication class, adjusted for age, sex and coprescribing. For those classes showing significance, it was also used to calculate risk differences between those in the IDA group with or without haemorrhagic lesions on investigation.Results A total of 1210 cases were analysed—409 in the IDA group, and 801 in the control group. Significant associations were identified between presentation with IDA and long-term exposure to PPIs (OR 3.29, 95% CI: 2.47 to 4.41, p<0.001) and to OACs (OR 2.04, 95% CI: 1.29 to 3.24, p=0.002). IDA was not associated with long-term exposure to any of the other three drug classes. In contrast to the relationship with PPIs, the association with OACs was primarily in the IDA sub-group with haemorrhagic lesions.Conclusion Long-term exposure to PPIs and OACs are independently associated with the risk of developing IDA. There are grounds for considering that these associations may be causal, though the underlying mechanisms probably differ.https://bmjopengastro.bmj.com/content/11/1/e001305.full |
| spellingShingle | Orouba Almilaji Jonathon Snook Kiran Prabhu Elizabeth Williams Frazer Warricker Role of prescribed medication in the development of iron deficiency anaemia in adults—a case–control study BMJ Open Gastroenterology |
| title | Role of prescribed medication in the development of iron deficiency anaemia in adults—a case–control study |
| title_full | Role of prescribed medication in the development of iron deficiency anaemia in adults—a case–control study |
| title_fullStr | Role of prescribed medication in the development of iron deficiency anaemia in adults—a case–control study |
| title_full_unstemmed | Role of prescribed medication in the development of iron deficiency anaemia in adults—a case–control study |
| title_short | Role of prescribed medication in the development of iron deficiency anaemia in adults—a case–control study |
| title_sort | role of prescribed medication in the development of iron deficiency anaemia in adults a case control study |
| url | https://bmjopengastro.bmj.com/content/11/1/e001305.full |
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