The Risk of Multiple Myeloma Is Reduced in Metformin Initiators: A Retrospective Cohort Study in Taiwanese Patients with Type 2 Diabetes Mellitus
Background: Whether metformin might reduce the risk of multiple myeloma (MM) has not been extensively researched in humans. Methods: The study subjects were enrolled from the reimbursement database of Taiwan’s National Health Insurance. A total of 739,553 patients who had a new diagnosis of type 2 d...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/22/5637 |
| _version_ | 1797465689028558848 |
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| author | Chin-Hsiao Tseng |
| author_facet | Chin-Hsiao Tseng |
| author_sort | Chin-Hsiao Tseng |
| collection | DOAJ |
| description | Background: Whether metformin might reduce the risk of multiple myeloma (MM) has not been extensively researched in humans. Methods: The study subjects were enrolled from the reimbursement database of Taiwan’s National Health Insurance. A total of 739,553 patients who had a new diagnosis of type 2 diabetes mellitus during 1999–2009 were identified. They were categorized as metformin initiators (metformin (+)) and non-metformin initiators (metformin (−)) based on the prescriptions of antidiabetic drugs that included metformin and did not include metformin within the initial 12 months, respectively. MM incidence was calculated after the initial 12 months of treatment group assignment until 31 December 2011. Hazard ratios based on intention-to-treat (ITT) and per-protocol (PP) approaches were estimated by Cox regression weighted by propensity scores. Results: In the ITT analyses, the respective incidence rates for 497,248 metformin (+) and 242,305 metformin (−) were 9.97 and 14.33 per 100,000 person-years. The hazard ratio that compared metformin (+) to metformin (−) in the ITT analysis was 0.710 (95% confidence interval 0.593–0.850). In the PP analysis, the respective incidence rates were 5.14 and 13.98 per 100,000 person-years, and the hazard ratio was 0.355 (95% confidence interval, 0.270–0.466). The lower risk of MM among metformin (+) was supported by subgroup and sensitivity analyses. Conclusions: Type 2 diabetes patients who are initiated with metformin treatment have a significantly lower risk of MM, especially when they adhere to metformin treatment. |
| first_indexed | 2024-03-09T18:26:04Z |
| format | Article |
| id | doaj.art-177ff393025045ac97a8ece6a2ed1a1d |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T18:26:04Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-177ff393025045ac97a8ece6a2ed1a1d2023-11-24T07:54:20ZengMDPI AGCancers2072-66942022-11-011422563710.3390/cancers14225637The Risk of Multiple Myeloma Is Reduced in Metformin Initiators: A Retrospective Cohort Study in Taiwanese Patients with Type 2 Diabetes MellitusChin-Hsiao Tseng0Department of Internal Medicine, National Taiwan University College of Medicine, Taipei 10051, TaiwanBackground: Whether metformin might reduce the risk of multiple myeloma (MM) has not been extensively researched in humans. Methods: The study subjects were enrolled from the reimbursement database of Taiwan’s National Health Insurance. A total of 739,553 patients who had a new diagnosis of type 2 diabetes mellitus during 1999–2009 were identified. They were categorized as metformin initiators (metformin (+)) and non-metformin initiators (metformin (−)) based on the prescriptions of antidiabetic drugs that included metformin and did not include metformin within the initial 12 months, respectively. MM incidence was calculated after the initial 12 months of treatment group assignment until 31 December 2011. Hazard ratios based on intention-to-treat (ITT) and per-protocol (PP) approaches were estimated by Cox regression weighted by propensity scores. Results: In the ITT analyses, the respective incidence rates for 497,248 metformin (+) and 242,305 metformin (−) were 9.97 and 14.33 per 100,000 person-years. The hazard ratio that compared metformin (+) to metformin (−) in the ITT analysis was 0.710 (95% confidence interval 0.593–0.850). In the PP analysis, the respective incidence rates were 5.14 and 13.98 per 100,000 person-years, and the hazard ratio was 0.355 (95% confidence interval, 0.270–0.466). The lower risk of MM among metformin (+) was supported by subgroup and sensitivity analyses. Conclusions: Type 2 diabetes patients who are initiated with metformin treatment have a significantly lower risk of MM, especially when they adhere to metformin treatment.https://www.mdpi.com/2072-6694/14/22/5637metforminmultiple myelomapharmacoepidemiological studyTaiwantype 2 diabetes mellitus |
| spellingShingle | Chin-Hsiao Tseng The Risk of Multiple Myeloma Is Reduced in Metformin Initiators: A Retrospective Cohort Study in Taiwanese Patients with Type 2 Diabetes Mellitus Cancers metformin multiple myeloma pharmacoepidemiological study Taiwan type 2 diabetes mellitus |
| title | The Risk of Multiple Myeloma Is Reduced in Metformin Initiators: A Retrospective Cohort Study in Taiwanese Patients with Type 2 Diabetes Mellitus |
| title_full | The Risk of Multiple Myeloma Is Reduced in Metformin Initiators: A Retrospective Cohort Study in Taiwanese Patients with Type 2 Diabetes Mellitus |
| title_fullStr | The Risk of Multiple Myeloma Is Reduced in Metformin Initiators: A Retrospective Cohort Study in Taiwanese Patients with Type 2 Diabetes Mellitus |
| title_full_unstemmed | The Risk of Multiple Myeloma Is Reduced in Metformin Initiators: A Retrospective Cohort Study in Taiwanese Patients with Type 2 Diabetes Mellitus |
| title_short | The Risk of Multiple Myeloma Is Reduced in Metformin Initiators: A Retrospective Cohort Study in Taiwanese Patients with Type 2 Diabetes Mellitus |
| title_sort | risk of multiple myeloma is reduced in metformin initiators a retrospective cohort study in taiwanese patients with type 2 diabetes mellitus |
| topic | metformin multiple myeloma pharmacoepidemiological study Taiwan type 2 diabetes mellitus |
| url | https://www.mdpi.com/2072-6694/14/22/5637 |
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