Login Register Cart 0
Generic placeholder image

Current Reviews in Clinical and Experimental Pharmacology

Editor-in-Chief

ISSN (Print): 2772-4328
ISSN (Online): 2772-4336

Back
Journal Home About Journal Editorial Board Current Issue Volumes/Issues
Subscribe
Meta-Analysis

Proton Pump Inhibitors’ Use and Risk of Iron Deficiency Anaemia: A Systematic Review and Meta-analysis

Author(s): Mohammad Daud Ali*

Volume 18, Issue 2, 2023

Published on: 12 April, 2022

Page: [158 - 166] Pages: 9

DOI: 10.2174/2772432817666220307121220

Price: $65

Abstract

Aim: Various research was conducted during the last decade, with inconsistent findings regarding iron death anaemia (IDA) perils vis-à-vis utilization of proton-pump inhibitors (PPIs). Consequently, recent systematic review and meta-analysis were implemented to evaluate IDA-related perils concerning the utilization of proton-pump inhibitors.

Methods: The databases of EBSCOhost, PubMed® and Cochrane Central were searched from the research outset until February 28, 2021 purposely to identify all research with objectives that align with the present research investigation. The Newcastle-Ottawa Scale (NOS) was utilized for the evaluation of the research investigation standard. The prime (1º) goal of the research was to gauge IDA peril among users of proton-pump inhibitors (PPI). For data processing, RevMan (Review Manager) version 5.4 was employed.

Results: In total, fourteen investigations research was employed in this systematic review and metaanalysis. The combined relative risk of nine research exhibited a numerically consequential interrelation betwixt the utilization of proton-pump inhibitors and IDA peril (RR 2.56 [95% CI 1.43–4.61], p < 0.00001). Contemporary systematic review and meta-analysis examination posit that proton-pump inhibitor consumers are prone to greater peril of coming down with IDA in comparison to non-PPI users.

Conclusion: In keeping with the findings of my research, prescriber physicians should exercise caution when prescribing PPIs to individuals taking it for a long time to avoid the peril of IDA. Additionally, their serum iron level should be checked to ensure that proton-pump inhibitors are safe.

Keywords: Iron deficiency anaemia, proton pump inhibitors, systematic review, meta-analysis, serum iron, risk.

« Previous Next »
Graphical Abstract

[1]
Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part I: Overall and upper gastrointestinal diseases. Gastroenterology 2009; 136(2): 376-86.
[http://dx.doi.org/10.1053/j.gastro.2008.12.015] [PMID: 19124023]
[2]
Kahrilas PJ, Shaheen NJ, Vaezi MF, et al. American gastroenterological association medical position statement on the management of gastroesophageal reflux disease. Gastroenterology 2008; 135(4): 1383-91.
[http://dx.doi.org/10.1053/j.gastro.2008.08.045]
[3]
Chan FK, Abraham NS, Scheiman JM, Laine L. Management of patients on nonsteroidal anti-inflammatory drugs: A clinical practice recommendation from the First International Working Party on Gastrointestinal and Cardiovascular Effects of Nonsteroidal Anti-inflammatory Drugs and Anti-platelet Agents. Am J Gastroenterol 2008; 103(11): 2908-18.
[http://dx.doi.org/10.1111/j.1572-0241.2008.02200.x] [PMID: 18853980]
[4]
Hoffmann F, Glaeske G, Schmiemann G. Underuse of proton-pump inhibitors in older patients newly starting NSAID treatment. Int J Clin Pract 2015; 69(7): 791-5.
[http://dx.doi.org/10.1111/ijcp.12611] [PMID: 25652848]
[5]
National Institute for Health and Care Excellence. 2014.Gastrooesophageal reflux disease and dyspepsia in adults: investigation and management. Available from: https://www.nice.org.uk/guidance/cg184
[6]
Freedberg DE, Kim LS, Yang YX. The risks and benefits of long-term use of proton pump inhibitors: Expert review and best practice advice from the American Gastroenterological Association. Gastroenterology 2017; 152(4): 706-15.
[http://dx.doi.org/10.1053/j.gastro.2017.01.031] [PMID: 28257716]
[7]
Lanza FL, Chan FK, Quigley EM. Practice Parameters Committee of the American College of Gastroenterology. Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol 2009; 104(3): 728-38.
[http://dx.doi.org/10.1038/ajg.2009.115] [PMID: 19240698]
[8]
Safer DJ. Overprescribed medications for US adults: Four major examples. J Clin Med Res 2019; 11(9): 617-22.
[http://dx.doi.org/10.14740/jocmr3906] [PMID: 31523334]
[9]
Nguyen PV, Tamaz R. Inappropriate prescription of proton pump inhibitors in a community setting. Can J Hosp Pharm 2018; 71(4): 267-71.
[http://dx.doi.org/10.4212/cjhp.v71i4.2828] [PMID: 30186000]
[10]
Kelly OB, Dillane C, Patchett SE, Harewood GC, Murray FE. The inappropriate prescription of oral proton pump inhibitors in the hospital setting: A prospective cross-sectional study. Dig Dis Sci 2015; 60(8): 2280-6.
[http://dx.doi.org/10.1007/s10620-015-3642-8] [PMID: 25840918]
[11]
IMS Health Report. IMS National Prescription Audit. 2010. Available from: https://www.iqvia.com/-/media/iqvia/pdfs /institutereports/medicines-use-andspending-shifts-in-the-us-in-2014.pdf [Accessed 26 July 2021].
[12]
Health Services Executive (HSE). Primary Care Reimbursement Services: Statistical Analysis of Claims and Payments Health Services Executive. (HSE): Dublin, Ireland 2009.
[13]
Ali MD, Ahmad A. A retrospective study on prescribing pattern and cost analysis of proton-pump inhibitors used among adults of Saudi Arabia. J Pharm Health Serv Res 2020; 11(4): 343-7.
[http://dx.doi.org/10.1111/jphs.12369]
[14]
Aitken M, Kleinrock M. Declining medicine use and costs: for better or worse? A review of the use of medicines in the United States. 2013. Available from: http://www.imshealth.com/cds/ims/Global/Content/Insights/IMS%20Institute%20for%20Healthcare%20Informatics/2012%20U.S.%20Medicines%20U.S.%20Medicines%20 [Accessed on: 26 Jul 202021].
[15]
Parente F, Cucino C, Gallus S, et al. Hospital use of acid-suppressive medications and its fall-out on prescribing in general practice: A 1-month survey. Aliment Pharmacol Ther 2003; 17(12): 1503-6.
[http://dx.doi.org/10.1046/j.1365-2036.2003.01600.x] [PMID: 12823152]
[16]
Mat Saad AZ, Collins N, Lobo MM, O’Connor HJ. Proton pump inhibitors: A survey of prescribing in an Irish general hospital. Int J Clin Pract 2005; 59(1): 31-4.
[http://dx.doi.org/10.1111/j.1742-1241.2004.00298.x] [PMID: 15707461]
[17]
Forgacs I, Loganayagam A. Overprescribing proton pump inhibitors. BMJ 2008; 336(7634): 2-3.
[http://dx.doi.org/10.1136/bmj.39406.449456.BE] [PMID: 18174564]
[18]
Imai R, Higuchi T, Morimoto M, Koyamada R, Okada S. Iron deficiency anemia due to the long-term use of a proton pump inhibitor. Intern Med 57(6): 899-901.
[http://dx.doi.org/10.2169/internalmedicine.9554-17]
[19]
Khalili H, Huang ES, Jacobson BC, Camargo CA Jr, Feskanich D, Chan AT. Use of proton pump inhibitors and risk of hip fracture in relation to dietary and lifestyle factors: A prospective cohort study. BMJ 2012; 344(jan30 5): e372.
[http://dx.doi.org/10.1136/bmj.e372] [PMID: 22294756]
[20]
Michael B. Iron deficiency anemia from iron malabsorption caused by proton pump inhibitors. eJHeam 2020; 1(2): 548-51.
[http://dx.doi.org/10.1002/jha2.96]
[21]
Douwes RM, Gomes-Neto AW, Eisenga MF, et al. Chronic use of proton-pump inhibitors and iron status in renal transplant recipients. J Clin Med 2019; 8(9): 1382.
[http://dx.doi.org/10.3390/jcm8091382] [PMID: 31484461]
[22]
Kaczmarczyk O. Przybylska-Feluś M, Piątek-Guziewicz A, et al. Effect of long-term proton pump inhibitor therapy on complete blood count parameters and selected trace elements: A pilot study. Pol Arch Intern Med 2020; 130(3): 179-86.
[http://dx.doi.org/10.20452/pamw.15101] [PMID: 31825323]
[23]
Sarzynski E, Puttarajappa C, Xie Y, Grover M, Laird-Fick H. Association between proton pump inhibitor use and anemia: A retrospective cohort study. Dig Dis Sci 2011; 56(8): 2349-53.
[http://dx.doi.org/10.1007/s10620-011-1589-y] [PMID: 21318590]
[24]
Muhammad HR. Examine the association of proton pump inhibitors with iron deficiency anemia. PJMHS 2020; 14(2): 546-8.
[25]
Tran-Duy A, Connell NJ, Vanmolkot FH, et al. Use of proton pump inhibitors and risk of iron deficiency: A population-based case-control study. J Intern Med 2019; 285(2): 205-14.
[http://dx.doi.org/10.1111/joim.12826] [PMID: 30141278]
[26]
Sharma N, Chau WY, Dobruskin L. Effect of long-term proton pump inhibitor therapy on hemoglobin and serum iron levels after sleeve gastrectomy. Surg Obes Relat Dis 2019; 15(10): 1682-9.
[http://dx.doi.org/10.1016/j.soard.2019.06.019] [PMID: 31422079]
[27]
Qorraj-Bytyqi H, Hoxha R, Sadiku S, et al. Proton pump inhibitors intake and iron and vitamin B12 status: A prospective comparative study with a follow up of 12 months. Open Access Maced J Med Sci 2018; 6(3): 442-6.
[http://dx.doi.org/10.3889/oamjms.2018.142]
[28]
Lam JR, Schneider JL, Quesenberry CP, Corley DA. Proton pump inhibitor and histamine-2 receptor antagonist use and iron deficiency. Gastroenterology 2017; 152(4): 821-829.e1.
[http://dx.doi.org/10.1053/j.gastro.2016.11.023] [PMID: 27890768]
[29]
Shalev H, Quider AA, Harosh MB, Kapelushnik J. Proton pump inhibitors use suppresses iron absorption in congenital dyserythropoietic anemia. Pediatr Hematol Oncol 2016; 33(7-8): 457-61.
[http://dx.doi.org/10.1080/08880018.2016.1247392] [PMID: 27960647]
[30]
Shikata T, Sasaki N, Ueda M, et al. Use of proton pump inhibitors is associated with anemia in cardiovascular outpatients. Circ J 2015; 79(1): 193-200.
[http://dx.doi.org/10.1253/circj.CJ-14-0582] [PMID: 25392070]
[31]
Attwood SE, Ell C, Galmiche JP, et al. Long-term safety of proton pump inhibitor therapy assessed under controlled, randomised clinical trial conditions: Data from the SOPRAN and LOTUS studies. Aliment Pharmacol Ther 2015; 41(11): 1162-74.
[http://dx.doi.org/10.1111/apt.13194] [PMID: 25858519]
[32]
Ajmera AV, Shastri GS, Gajera MJ, Judge TA. Suboptimal response to ferrous sulfate in iron-deficient patients taking omeprazole. Am J Ther 2012; 19(3): 185-9.
[http://dx.doi.org/10.1097/MJT.0b013e3181f9f6d2] [PMID: 21150767]
[33]
Hutchinson C, Geissler CA, Powell JJ, Bomford A. Proton pump inhibitors suppress absorption of dietary non-haem iron in hereditary haemochromatosis. Gut 2007; 56(9): 1291-5.
[http://dx.doi.org/10.1136/gut.2006.108613] [PMID: 17344278]
[34]
Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions. West Sussex, England: John Wiley & Sons 2011.
[35]
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann Intern Med 2009; 151(4): 264-269, W64.
[http://dx.doi.org/10.7326/0003-4819-151-4-200908180-00135] [PMID: 19622511]
[36]
Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: A proposal for reporting. JAMA 2000; 283(15): 2008-12.
[http://dx.doi.org/10.1001/jama.283.15.2008]
[37]
Cornell JE, Mulrow CD, Localio R, et al. Random-effects meta-analysis of inconsistent effects: A time for change. Ann Intern Med 2014; 160(4): 267-70.
[http://dx.doi.org/10.7326/M13-2886]
[38]
George BJ, Aban IB. An application of meta-analysis based on DerSimonian and Laird method. J Nucl Cardiol 2016; 23(4): 690-2.
[http://dx.doi.org/10.1007/s12350-015-0249-6] [PMID: 26245193]
[39]
Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315(7109): 629-34.
[http://dx.doi.org/10.1136/bmj.315.7109.629] [PMID: 9310563]
[40]
Review Manager (RevMan) [Computer program] Version 5.4 Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration. 2020.
[41]
Sharma VR, Brannon MA, Carloss EA. Effect of omeprazole on oral iron replacement in patients with iron deficiency anemia. South Med J 2004; 97(9): 887-9.
[http://dx.doi.org/10.1097/01.SMJ.0000110405.63179.69] [PMID: 15455980]
[42]
Stewart CA, Termanini B, Sutliff VE, et al. Iron absorption in patients with Zollinger-Ellison syndrome treated with long-term gastric acid antisecretory therapy. Aliment Pharmacol Ther 1998; 12(1): 83-98.
[http://dx.doi.org/10.1046/j.1365-2036.1998.00274.x] [PMID: 9692706]

Rights & Permissions Print Cite
Article Metrics
48
2
© 2024 Bentham Science Publishers | Privacy Policy