https://scholars.lib.ntu.edu.tw/handle/123456789/558311
標題: | Metformin Use and Leukemia Risk in Patients With Type 2 Diabetes Mellitus | 作者: | CHIN-HSIAO TSENG | 關鍵字: | diabetes mellitus; leukemia; metformin; National Health Insurance; Taiwan | 公開日期: | 2020 | 出版社: | Frontiers Media S.A. | 卷: | 11 | 起(迄)頁: | 541090 | 來源出版物: | Frontiers in Endocrinology | 摘要: | Background: The effect of metformin on leukemia risk remains unknown. Methods: The Taiwan’s National Health Insurance database was used to enroll 610,089 newly diagnosed type 2 diabetes patients on at least 2 anti-diabetic prescriptions during 1999–2009. We followed-up these patients until 31 December 2011, in order to determine the incidence of leukemia. We used Cox regression model (incorporated with the inverse probability of treatment-weighting using propensity scores) to estimate hazard ratios in both intention-to-treat and per-protocol analyses. Results: We enrolled 414,783 metformin initiators and 195,306 non-metformin initiators. Among them, 598 and 372 patients developed new-onset leukemia after a median follow-up period of 5.08 years and 6.79 years, respectively. The respective incidence rates were 26.52 and 28.40 per 100,000 person-years. The hazard ratio for metformin initiators versus non-metformin initiators was 0.943 (95% confidence interval 0.828–1.074) in the intention-to-treat analysis and 0.852 (95% confidence interval 0.705–1.031) in the per-protocol analysis. Sensitivity analyses after excluding patients using the exclusion criteria (a follow-up duration < 24 and < 36 months, respectively, patients with incretin-based therapies during follow-up, and patients enrolled during 2 different periods of 1999–2003 and 2004–2009) consistently showed a neutral effect. However, metformin initiators had a significantly higher risk of leukemia in the per-protocol analyses when censoring patients at a time without regular follow-up. Conclusion: Metformin use has an overall neutral effect on leukemia but we cannot exclude a significantly higher risk in patients who persistently use the drug. ? Copyright ? 2020 Tseng. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85095705333&doi=10.3389%2ffendo.2020.541090&partnerID=40&md5=afb20e43ebd85e4067bb99cba3cba825 https://scholars.lib.ntu.edu.tw/handle/123456789/558311 |
ISSN: | 1664-2392 | DOI: | 10.3389/fendo.2020.541090 | SDG/關鍵字: | metformin; adult; anemia; Article; comorbidity; dyslipidemia; eye disease; female; follow up; human; leukemia; major clinical study; male; non insulin dependent diabetes mellitus; obesity; prescription; risk factor; sensitivity analysis |
顯示於: | 醫學系 |
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