When using the function FPDFPage_Delete to remove a page from a PDF and then saving with FPDF_SaveAsCopy, the operation appears to succeed (page does not appear in any PDF viewer). However, the new copy has a larger file size than the original. This is also true for any amount of pages deleted i.e., deleting all but one page results in larger file size)
This exists in the original Foxit SDK (upon which PDFium is based). An example is given here:
https://stackoverflow.com/questions/24371859/foxit-pdf-sdk-delete-page-increases-document-size