Abstract:
BACKGROUND:Multiple myeloma is one of the most common haematological malignancies in the USA and is consistently preceded by monoclonal gammopathy of undetermined significance (MGUS). We aimed to assess the association between metformin use and progression of MGUS to multiple myeloma. METHODS:We did a retrospective cohort study of patients registered in the US Veterans Health Administration database and diagnosed with MGUS between Oct 1, 1999, and Dec 31, 2009. We included patients (aged >18 years) with at least one International Classification of Diseases (9th revision) code for diabetes mellitus and one treatment for their diabetes before MGUS diagnosis. We reviewed patient-level clinical data to verify diagnoses and extract any available data for size of baseline M-protein and type of MGUS. We defined metformin users as patients with diabetes who were given metformin consistently for 4 years after their diabetes diagnosis and before multiple myeloma development, death, or censorship. Our primary outcome was time from MGUS diagnosis to multiple myeloma diagnosis. We used Kaplan-Meier curves and Cox models to analyse the association between metformin use and MGUS progression. FINDINGS:We obtained data for 3287 patients, of whom 2003 (61%) were included in the final analytical cohort. Median follow-up was 69 months (IQR 49–96). 463 (23%) participants were metformin users and 1540 (77%) participants were non-users. 13 (3%) metformin users progressed to multiple myeloma compared with 74 (5%) non-users. After adjustment, metformin use was associated with a reduced risk of progression to multiple myeloma (hazard ratio 0·47, 95% CI 0·25–0·87). INTERPRETATION:For patients with diabetes diagnosed with MGUS, metformin use for 4 years or longer was associated with a reduced risk of progression of MGUS to multiple myeloma. Prospective studies are needed to establish whether this association is causal and whether these results can be extrapolated to non-diabetic individuals. FUNDING:Barnes-Jewish Hospital Foundation, National Institutes of Health, Agency for Healthcare Research and Quality, American Cancer Society.
journal_name
Lancet Haematoljournal_title
The Lancet. Haematologyauthors
Chang SH,Luo S,O'Brian KK,Thomas TS,Colditz GA,Carlsson NP,Carson KRdoi
10.1016/S2352-3026(14)00037-4subject
Has Abstractpub_date
2015-01-01 00:00:00pages
e30-6issue
1issn
2352-3026pii
S2352-3026(14)00037-4journal_volume
2pub_type
杂志文章abstract::Machine learning is a branch of computer science and statistics that generates predictive or descriptive models by learning from training data rather than by being rigidly programmed. It has attracted substantial attention for its many applications in medicine, both as a catalyst for research and as a means of improvi...
journal_title:The Lancet. Haematology
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abstract:BACKGROUND:Panobinostat (a pan histone deacetylase inhibitor) is approved in combination with bortezomib and dexamethasone for patients with relapsed multiple myeloma who have received two or more previous lines of therapy. We aimed to improve the safety of this combination and investigate efficacy by incorporating low...
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journal_title:The Lancet. Haematology
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journal_title:The Lancet. Haematology
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journal_title:The Lancet. Haematology
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pub_type: 临床试验,杂志文章
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journal_title:The Lancet. Haematology
pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,多中心研究
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journal_title:The Lancet. Haematology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2021-01-01 00:00:00