Use of metformin and survival of diabetic women with breast cancer.
Use of metformin and survival of diabetic women with breast cancer.
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DOI：
10.2174/15680266113136660069
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发表时间：
2013-11
影响因子：
1.5
通讯作者：
De Bruin ML
中科院分区：
文献类型：
--
作者：
Peeters PJ;Bazelier MT;Vestergaard P;Leufkens HG;Schmidt MK;de Vries F;De Bruin ML
目的：本研究旨在确定二甲双胍的使用是否影响接受降糖药物治疗的乳腺癌患者与非使用者相比的生存率。研究设计和方法：我们使用丹麦国家登记处（1996-2008年）的数据，以确定诊断为乳腺癌并接受降糖药物治疗的成年女性患者。我们进行了多变量Cox比例风险回归，以评估与二甲双胍暴露相关的全因和乳腺癌特异性死亡风险。在次要分析中，我们根据累积处方数量对二甲双胍的使用进行分层。结果：1058例乳腺癌患者中，349例在随访期间死亡，其中152例的主要死亡原因为乳腺癌。与未使用相比，当前二甲双胍治疗与总体死亡率显著降低相关（校正HR 0.74，95% CI，0.58-0.96）。对于乳腺癌特异性死亡率，观察到非显著性风险降低（校正的HR 0.88，95% CI，0.59-1.29），根据累积处方数分层后变得显著。在二甲双胍停药后的前12个月内，观察到总体死亡率和乳腺癌特异性死亡率的风险增加。结论：我们观察到在接受抗糖尿病药物治疗的乳腺癌患者中，与二甲双胍暴露相关的乳腺癌特异性死亡率无显著降低。然而，我们的研究结果表明，长期使用二甲双胍可能对乳腺癌患者的生存有有益的影响。需要进一步证实这些发现。
Objective: This study was set out to determine whether metformin use influences survival in breast cancer patients treated with antidiabetic drugs as compared to non-users. Research Design and Methods: We used data from the Danish national registries (1996-2008) to identify adult female patients diagnosed with breast cancer who were prescribed antidiabetic medication. We performed multivariate Cox-proportional hazard regression to assess all-cause and breast cancer-specific mortality risks associated with metformin exposure. In a secondary analysis, we stratified use of metformin according to the cumulative number of prescriptions. Results: Of the 1058 breast cancer patients 349 died during follow-up, with breast cancer listed as the primary cause of death for 152 cases. Compared to non-use, current metformin treatment was associated with a significant reduction in overall mortality (adjusted HR 0.74, 95% CI, 0.58-0.96). For breast cancer-specific mortality, a non-significant risk reduction (adjusted HR 0.88, 95% CI, 0.59-1.29) was observed, which became significant after stratification according to cumulative number of prescriptions. An increased risk of both overall and breast cancer-specific mortality was observed in the first 12 months after discontinuation of metformin. Conclusions: We observed a nonsignificant reduction in breast cancer-specific mortality associated with metformin exposure among breast cancer patients treated with antidiabetic drugs. However, our findings suggest that long-term metformin use may have a beneficial effect on survival in patients with breast cancer. Further confirmation of these findings is needed.