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Influence of metformin intake on the risk of bladder cancer in type 2 diabetes patients
Author(s) -
Goossens Maria E.,
Buntinx Frank,
Zeegers Maurice P.,
Driessen J.H.M.,
De Bruin Marie L.,
De Vries Frank
Publication year - 2015
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.12740
Subject(s) - metformin , medicine , type 2 diabetes , sulfonylurea , cohort , diabetes mellitus , cohort study , proportional hazards model , retrospective cohort study , lower risk , cancer , insulin , endocrinology , confidence interval
Aim The aim of this study was to look at the influence of metformin intake and duration, on urinary bladder cancer (UBC) risk, with sulfonylurea (SU) only users as control using a new user design (inception cohort). Methods We conducted a retrospective cohort study using data from the UK Clinical Practice Research Datalink (CPRD) including all patients with at least one prescription of oral anti‐diabetic drugs (ADD) and/or insulin. The risk of UBC in different groups of ADD users (metformin alone (one), metformin in combination (two) with other ADD medication (glinides, glitazones, DPP‐4‐inhibitors, SUs, insulin or more than one combination), all metformin users (1 + 2) was compared with SU only users using Cox proportional hazards models. The estimates were adjusted for age, gender, smoking status, BMI and diabetes duration. Results The inception cohort included 165 398 participants of whom 132 960 were metformin users and 32 438 were SU only users. During a mean follow‐up time of more than 5 years 693 patients developed UBC, 124 of the control group and 461 of the all metformin users. There was no association between metformin use and UBC risk (HR = 1.12, 95% CI 0.90, 1.40) compared with SU only users, even after adjustment for diabetes duration (HR = 1.13, 95% CI 0.90, 1.40). We found a pattern of decreasing risk of UBC with increasing duration of metformin intake, which was statistically not significant. Conclusion Metformin has no influence on the risk of UBC compared with SU in type 2 diabetes patients using a new user design.