Metformin use and long-term risk of benign prostatic hyperplasia: a population-based cohort study

Objective To assess whether metformin use affects risk of benign prostatic hyperplasia (BPH) by comparing the risk of BPH in men with type 2 diabetes who initiated first-line treatment with either metformin or sulfonylurea monotherapy between 2000 or 2006 in Northern Denmark. In this period, sulfony...

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Autor principal:	Bianka Darvalics
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2020
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/d4b591fc2296480c9bfd02e50274811a
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spelling	oai:doaj.org-article:d4b591fc2296480c9bfd02e50274811a2021-11-18T05:00:07ZMetformin use and long-term risk of benign prostatic hyperplasia: a population-based cohort study10.1136/bmjopen-2020-0418752044-6055https://doaj.org/article/d4b591fc2296480c9bfd02e50274811a2020-12-01T00:00:00Zhttps://bmjopen.bmj.com/content/10/12/e041875.fullhttps://doaj.org/toc/2044-6055Objective To assess whether metformin use affects risk of benign prostatic hyperplasia (BPH) by comparing the risk of BPH in men with type 2 diabetes who initiated first-line treatment with either metformin or sulfonylurea monotherapy between 2000 or 2006 in Northern Denmark. In this period, sulfonylurea and metformin were both frequently used as first-line glucose-lowering drug (GLD) treatment.Design A population-based cohort study.Setting Northern Denmark.Participants All men who filled at least two prescriptions for metformin or for sulfonylurea, respectively, during their first 6 months of GLD treatment. Follow-up started 6 months after treatment start.Primary outcome measures Rates of subsequent BPH, identified based on community prescriptions for BPH-related treatment or hospital BPH diagnoses, and rates of transurethral resection of the prostate (TURP). Rates in metformin and sulfonylurea users were compared overall and stratified by 6-month haemoglobin A1c (HbA1c) using Cox regression and an intention-to-treat (ITT) approach and an as-treated analysis.Results During follow-up, less than five persons were lost to follow-up due to emigration. In 3953 metformin initiators with a median follow-up of 10 years, the 10-year cumulative BPH incidence was 25.7% (95% CI 24.2 to 27.1). Compared with 5958 sulfonylurea users (median follow-up 8 years, 10-year cumulative incidence 27.4% (95% CI 26.2 to 28.6)), the crude HR for BPH was 0.83 (95% CI 0.77 to 0.89) and adjusted HR in the ITT analyses was 0.97 (95% CI 0.88 to 1.06). For TURP, the adjusted HR was 0.96 (95% CI 0.63 to 1.46). In the as-treated analysis, adjusted HR for BPH was 0.91 (95% CI 0.81 to 1.02).Conclusions Compared with sulfonylurea, metformin did not substantially reduce the incidence of BPH in men with diabetes.Bianka DarvalicsBMJ Publishing GrouparticleMedicineRENBMJ Open, Vol 10, Iss 12 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Bianka Darvalics Metformin use and long-term risk of benign prostatic hyperplasia: a population-based cohort study
description	Objective To assess whether metformin use affects risk of benign prostatic hyperplasia (BPH) by comparing the risk of BPH in men with type 2 diabetes who initiated first-line treatment with either metformin or sulfonylurea monotherapy between 2000 or 2006 in Northern Denmark. In this period, sulfonylurea and metformin were both frequently used as first-line glucose-lowering drug (GLD) treatment.Design A population-based cohort study.Setting Northern Denmark.Participants All men who filled at least two prescriptions for metformin or for sulfonylurea, respectively, during their first 6 months of GLD treatment. Follow-up started 6 months after treatment start.Primary outcome measures Rates of subsequent BPH, identified based on community prescriptions for BPH-related treatment or hospital BPH diagnoses, and rates of transurethral resection of the prostate (TURP). Rates in metformin and sulfonylurea users were compared overall and stratified by 6-month haemoglobin A1c (HbA1c) using Cox regression and an intention-to-treat (ITT) approach and an as-treated analysis.Results During follow-up, less than five persons were lost to follow-up due to emigration. In 3953 metformin initiators with a median follow-up of 10 years, the 10-year cumulative BPH incidence was 25.7% (95% CI 24.2 to 27.1). Compared with 5958 sulfonylurea users (median follow-up 8 years, 10-year cumulative incidence 27.4% (95% CI 26.2 to 28.6)), the crude HR for BPH was 0.83 (95% CI 0.77 to 0.89) and adjusted HR in the ITT analyses was 0.97 (95% CI 0.88 to 1.06). For TURP, the adjusted HR was 0.96 (95% CI 0.63 to 1.46). In the as-treated analysis, adjusted HR for BPH was 0.91 (95% CI 0.81 to 1.02).Conclusions Compared with sulfonylurea, metformin did not substantially reduce the incidence of BPH in men with diabetes.
format	article
author	Bianka Darvalics
author_facet	Bianka Darvalics
author_sort	Bianka Darvalics
title	Metformin use and long-term risk of benign prostatic hyperplasia: a population-based cohort study
title_short	Metformin use and long-term risk of benign prostatic hyperplasia: a population-based cohort study
title_full	Metformin use and long-term risk of benign prostatic hyperplasia: a population-based cohort study
title_fullStr	Metformin use and long-term risk of benign prostatic hyperplasia: a population-based cohort study
title_full_unstemmed	Metformin use and long-term risk of benign prostatic hyperplasia: a population-based cohort study
title_sort	metformin use and long-term risk of benign prostatic hyperplasia: a population-based cohort study
publisher	BMJ Publishing Group
publishDate	2020
url	https://doaj.org/article/d4b591fc2296480c9bfd02e50274811a
work_keys_str_mv	AT biankadarvalics metforminuseandlongtermriskofbenignprostatichyperplasiaapopulationbasedcohortstudy
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Metformin use and long-term risk of benign prostatic hyperplasia: a population-based cohort study

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