TY - JOUR
T1 - Risk of New-Onset Prostate Cancer for Metformin Versus Sulfonylurea Use in Type 2 Diabetes Mellitus
T2 - A Propensity Score-Matched Study
AU - Lee, Yan Hiu Athena
AU - Zhou, Jiandong
AU - Hui, Jeremy Man Ho
AU - Liu, Xuejin
AU - Lee, Teddy Tai Loy
AU - Hui, Kyle
AU - Chan, Jeffrey Shi Kai
AU - Wai, Abraham Ka Chung
AU - Wong, Wing Tak
AU - Liu, Tong
AU - Ng, Kenrick
AU - Lee, Sharen
AU - Dee, Edward Christopher
AU - Zhang, Qingpeng
AU - Tse, Gary
N1 - Publisher Copyright:
© 2022 Harborside Press. All rights reserved.
PY - 2022/6
Y1 - 2022/6
N2 - The aim of this study was to compare the risks of newonset prostate cancer between metformin and sulfonylurea users with type 2 diabetes mellitus (T2DM). Methods: This populationbased retrospective cohort study included male patients with T2DM presenting to public hospitals/clinics in Hong Kong between January 1, 2000, and December 31, 2009. We only included patients prescribed either, but not both, metformin or sulfonylurea. All patients were followed up until December 31, 2019. The primary outcome was new-onset prostate cancer and the secondary outcome was all-cause mortality. One-to-one propensity score matching was performed between metformin and sulfonylurea users based on demographics, comorbidities, antidiabetic and cardiovascular medications, fasting blood glucose level, and hemoglobin A1c level. Subgroup analyses based on age and use of androgen deprivation therapy were performed. Results: The final study cohort consisted of 25,695 metformin users (mean [SD] age, 65.2 [11.8] years) and 25,695 matched sulfonylurea users (mean [SD] age, 65.3 [11.8] years) with a median follow-up duration of 119.6 months (interquartile range, 91.7-139.6 months) after 1:1 propensity score matching of 66,411 patients. Metformin users had lower risks of new-onset prostate cancer (hazard ratio, 0.80; 95% CI, 0.69-0.93; P5.0031) and all-cause mortality (hazard ratio, 0.89; 95% CI, 0.86-0.92; P,.0001) than sulfonylurea users. Metformin use was more protective against prostate cancer but less protective against all-cause mortality in patients aged ,65 years (P for trend ,.0001 for both) compared with patients aged $65 years. Metformin users had lower risk of all-cause mortality than sulfonylurea users, regardless of the use of androgen deprivation therapy (P for trend ,.0001) among patients who developed prostate cancer. Conclusions: Metformin use was associated with significantly lower risks of new-onset prostate cancer and allcausemortality than sulfonylurea use inmale patients with T2DM.
AB - The aim of this study was to compare the risks of newonset prostate cancer between metformin and sulfonylurea users with type 2 diabetes mellitus (T2DM). Methods: This populationbased retrospective cohort study included male patients with T2DM presenting to public hospitals/clinics in Hong Kong between January 1, 2000, and December 31, 2009. We only included patients prescribed either, but not both, metformin or sulfonylurea. All patients were followed up until December 31, 2019. The primary outcome was new-onset prostate cancer and the secondary outcome was all-cause mortality. One-to-one propensity score matching was performed between metformin and sulfonylurea users based on demographics, comorbidities, antidiabetic and cardiovascular medications, fasting blood glucose level, and hemoglobin A1c level. Subgroup analyses based on age and use of androgen deprivation therapy were performed. Results: The final study cohort consisted of 25,695 metformin users (mean [SD] age, 65.2 [11.8] years) and 25,695 matched sulfonylurea users (mean [SD] age, 65.3 [11.8] years) with a median follow-up duration of 119.6 months (interquartile range, 91.7-139.6 months) after 1:1 propensity score matching of 66,411 patients. Metformin users had lower risks of new-onset prostate cancer (hazard ratio, 0.80; 95% CI, 0.69-0.93; P5.0031) and all-cause mortality (hazard ratio, 0.89; 95% CI, 0.86-0.92; P,.0001) than sulfonylurea users. Metformin use was more protective against prostate cancer but less protective against all-cause mortality in patients aged ,65 years (P for trend ,.0001 for both) compared with patients aged $65 years. Metformin users had lower risk of all-cause mortality than sulfonylurea users, regardless of the use of androgen deprivation therapy (P for trend ,.0001) among patients who developed prostate cancer. Conclusions: Metformin use was associated with significantly lower risks of new-onset prostate cancer and allcausemortality than sulfonylurea use inmale patients with T2DM.
UR - http://www.scopus.com/inward/record.url?scp=85132454441&partnerID=8YFLogxK
U2 - 10.6004/jnccn.2022.7010
DO - 10.6004/jnccn.2022.7010
M3 - Article
C2 - 35714677
AN - SCOPUS:85132454441
SN - 1540-1405
VL - 20
SP - 674
EP - 682
JO - JNCCN Journal of the National Comprehensive Cancer Network
JF - JNCCN Journal of the National Comprehensive Cancer Network
IS - 6
ER -