Association Between Proton Pump Inhibitor Use and Anemia: A Retrospective Cohort Study
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Proton pump inhibitors (PPIs) are widely prescribed to treat gastrointestinal diseases. However, concerns have been raised regarding their long-term use. Gastric acid suppression may decrease iron absorption, and it remains uncertain whether iron-deficiency anemia may result from chronic PPI therapy.
We aimed to explore the association between chronic PPI use and iron-deficiency anemia.
We conducted a retrospective cohort study of adult patients in an academic outpatient setting who received PPI therapy for at least 1 year between January 1, 2004 and January 1, 2006. We compared the change in hematologic indices among patients receiving PPI therapy for at least 1 year with matched controls.
Of the 98 patients on chronic PPI therapy who met inclusion criteria, 35% had no documented indication for such therapy. At baseline, demographics and hematologic indices were similar between PPI-users and controls. Among patients on PPI therapy, all hematologic indices decreased from baseline, including hemoglobin (−0.19 g/dL, P = 0.03), hematocrit (−0.63%, P = 0.02), and mean corpuscular volume (−0.49 fL, P = 0.05). PPI users had significant decreases in mean hemoglobin and hematocrit (P < 0.01 for both) compared with matched controls. After adjustment for confounders, including rates of esophagogastroduodenoscopy, colonoscopy and remote cancer status, the odds ratio of decreasing hemoglobin by 1.0 g/dL while on chronic PPI therapy was 5.03 (95% CI, 1.71–14.78, P < 0.01), while the odds ratio of decreasing hematocrit by 3% was 5.46 (95% CI, 1.67–17.85, P < 0.01).
Among adult patients receiving chronic PPI therapy, there is a significant decrease in hematologic indices from baseline.
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- Association Between Proton Pump Inhibitor Use and Anemia: A Retrospective Cohort Study
Digestive Diseases and Sciences
Volume 56, Issue 8 , pp 2349-2353
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Proton pump inhibitor
- Iron deficiency
- Industry Sectors
- Author Affiliations
- 1. Department of Medicine, Michigan State University, B-301 Clinical Center, East Lansing, MI, 48824, USA
- 2. Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh, A919 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA, 15261, USA
- 3. Center for Statistical Training and Consulting, Michigan State University, 178 Giltner Hall, East Lansing, MI, 48824, USA
- 4. Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA