medwireNews: Metformin use is associated with a significant reduction in the risk for total knee or hip replacement among people with type 2 diabetes, shows research published in CMAJ.
These findings suggest that “[r]andomized controlled clinical trials in patients with osteoarthritis [OA] are warranted to determine whether metformin is effective in decreasing the need for joint replacement,” say Changhai Ding (Zhujiang Hospital, Southern Medical University, Guangzhou, China) and colleagues.
The study included 20,347 people from the Taiwan National Health Insurance Research Database who were diagnosed with type 2 diabetes in 2000–2012 and were treated with metformin, and the same number of matched individuals with type 2 diabetes who were not given metformin. A total of 837 people underwent total knee replacement (TKR; 97.5% due to OA) and 148 underwent total hip replacement (THR; 50.7% due to OA).
As reported in CMAJ, metformin users had a significantly lower incidence of hip or knee replacement than nonusers during the study period, at 3.40 versus 4.99 per 10,000 person–months and a hazard ratio (HR) of 0.70 after adjustment for confounders. This association remained significant when TKR and THR were evaluated separately, at adjusted HRs of 0.71 and 0.61, respectively.
Ding et al say that a similar pattern of results was seen in a sensitivity analysis using the alternative outcome of hospital admission rates for knee or hip OA, and when the analysis was restricted to OA-related joint replacements.
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