Role of prescribed medication in the development of iron deficiency anaemia in adults-a case-control study.

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY
Kiran Prabhu, Frazer Warricker, Orouba Almilaji, Elizabeth Williams, Jonathon Snook
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引用次数: 0

Abstract

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.

处方药在成人缺铁性贫血发病中的作用--病例对照研究。
目的估算某些处方药与缺铁性贫血(IDA)发病风险之间的相关性,特别是口服抗凝药(OAC)、抗抑郁药、抗血小板药、质子泵抑制剂(PPI)和非甾体抗炎药:设计:一项病例对照研究,分析因 IDA 而转诊的受试者和因其他适应症而作为消化内科快速通道转诊的未匹配对照者的社区重复处方。采用多变量逻辑回归模型计算IDA病症与各类药物之间的相关性,并对年龄、性别和共同处方进行调整。对于显示出显著性的药物类别,该模型还用于计算IDA组中有或没有出血病变的调查对象之间的风险差异:共分析了 1210 个病例,其中 IDA 组有 409 个,对照组有 801 个。结果:共分析了1210例IDA病例--409例IDA组病例和801例对照组病例,发现IDA病例与长期服用PPIs之间存在显著关联(OR 3.29,95% CI:2.47至4.41,p):长期服用 PPIs 和 OACs 与罹患 IDA 的风险独立相关。有理由认为这些关联可能是因果关系,尽管其潜在机制可能有所不同。
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来源期刊
BMJ Open Gastroenterology
BMJ Open Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.90
自引率
3.20%
发文量
68
审稿时长
2 weeks
期刊介绍: BMJ Open Gastroenterology is an online-only, peer-reviewed, open access gastroenterology journal, dedicated to publishing high-quality medical research from all disciplines and therapeutic areas of gastroenterology. It is the open access companion journal of Gut and is co-owned by the British Society of Gastroenterology. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around continuous publication, publishing research online as soon as the article is ready.
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