Effects of early medication treatment and metformin use for cancer prevention in diabetes patients: a nationwide sample cohort study in Korea using extended landmark time analysis

Abstract

Effects of early medication treatment and metformin use for cancer prevention in diabetes patients: a nationwide sample cohort study using extended landmark-time analysis Abstract Objectives: This study aimed to demonstrate the effectiveness of early medication treatment and metformin use for cancer prevention in type 2 diabetes patients. Methods: A population-based cohort data was used from the Korean National Health Insurance Service-National Sample Cohort database (KNHIS-NSC) for 2002-2013.Patient-specific medication prescription status was defined by the landmark-time (LMT; a fixed-time after cohort entry), considering both pre-and post-LMT prescription drugs to control methodological biases in observational study. LMT was set to 2 years.Logistic regression analysis with multivariable adjustment was conducted to analyze the cancer incidence by patient-specific medication prescription status.Results: Only 33.36% of the subjects were prescribed medication early (before LMT) with compliance. Cancer incidence with early prescription and compliance was 25% lower (OR=0.75, 95% CI=0.67-0.84) than those without, and as an early prescribing medication, metformin monotherapy and metformin combination therapy had a 34% (OR=0.66, 95% CI=0.51-0.83) and 25% (OR=0.75, 95% CI=0.64-0.88) lower cancer risk than non-users, respectively. Patients who were prescribed late (after LMT) but did not comply with the prescription had a 24% (OR=1.24, 95% CI=0.97-1.58) higher cancer incidence than non-users. Among patients started monotherapy early and unchanged through the entire follow-up, those who started on metformin had a 37% E p u ba h e a d o f p r i n t 2 (OR=0.63, 95% CI=0.41-0.99) lower risk of cancer than non-metformin.Conclusions: Doctors must prescribe antidiabetic medication early, and the patient must comply with the prescribed medication regardless of the time of prescription to prevent cancer in diabetic patients. Metformin monotherapy or combination is recommended as early prescription.

Combination of Metformin and Sorafenib Induces Ferroptosis of Hepatocellular Carcinoma Through p62-Keap1-Nrf2 Pathway

“…Metformin, which is widely used as anti-diabetic drug, has demonstrated important anti-cancer effects both in vitro and in vivo in many studies [16][17][18]. Metformin combination with other treatment strategies has also been widely reported [19].…”