Inverse Association between Metformin and Amiodarone-Associated Extracardiac Adverse Events
Inverse Association between Metformin and Amiodarone-Associated Extracardiac Adverse Events
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DOI：
10.7150/ijms.39342
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发表时间：
2020-01-01
影响因子：
3.6
通讯作者：
Takada, Mitsutaka
中科院分区：
文献类型：
--
作者：
Kinoshita, Sayoko;Hosomi, Kouichi;Takada, Mitsutaka
背景：使用自发不良事件数据库检查二甲双胍和胺碘酮引起的不良事件之间的关联。此外，还检查了其他抗糖尿病药物与胺碘酮引起的不良事件之间的关联。方法：从美国食品和药物管理局不良事件报告系统下载了2004年第一季度至2015年第四季度总共6,153,696份报告。报告比值比 (ROR) 和信息成分 (IC) 用于检测抗糖尿病药物与胺碘酮相关不良事件之间的关联。此外，还进行了子集数据分析，以调查抗糖尿病药物的使用是否会进一步增加或降低接受胺碘酮治疗的患者发生不良事件的风险。接下来，使用逻辑回归分析对联合用药抗糖尿病药物的 ROR 进行调整。结果：通过整个数据集分析，发现二甲双胍与间质性肺疾病之间存在显着负相关（ROR 0.84，95% 置信区间 [CI] 0.79-0.90；IC -0.24，95% CI -0.33 至 -0.15）。在子集数据分析中，二甲双胍（ROR 0.62，95%CI 0.43-0.89；IC -0.63，95%CI -1.14至-0.11）、磺脲类（ROR 0.53，95%CI 0.32-0.85；IC -0.85，95%CI -1.53至-0.17）和二肽基 肽酶 4 (DPP-4) 抑制剂（ROR 0.25，95%CI 0.08-0.78；IC -1.66，95%CI -3.08 至 -0.23）与甲状腺功能亢进呈负相关。此外，二甲双胍（ROR 0.43，95%CI 0.33-0.57；IC -1.09，95%CI -1.49 至 -0.69）、磺酰脲类（ROR 0.64，95%CI 0.48-0.86；IC -0.59，95%CI -1.00 至 -0.17）和 DPP-4抑制剂（ROR 0.47，95%CI 0.27-0.81； IC -0.99，95% CI -1.76 至 -0.22）与间质性肺疾病呈负相关。在逻辑回归分析中，DPP-4抑制剂（调整后的ROR 0.32，95％CI 0.10-1.00）和二甲双胍（调整后的ROR 0.46，95％CI 0.34-0.62）分别与胺碘酮相关的甲状腺功能亢进症和间质性肺病呈负相关。结论：二甲双胍是降低甲状腺功能亢进风险的候选药物。 胺碘酮诱发的甲状腺功能亢进症和间质性肺疾病。
Background: The association between metformin and amiodarone-induced adverse events was examined using spontaneous adverse event database. Additionally, the association between other antidiabetic drugs and amiodarone-induced adverse events were also examined.Methods: A total of 6,153,696 reports from the first quarter of 2004 through the fourth quarter of 2015 were downloaded from the US Food and Drug Administration adverse event reporting system. Reporting odds ratio (ROR) and information component (IC) were used to detect associations between antidiabetic drugs and amiodarone-associated adverse events. Additionally, subset data analysis was performed to investigate whether the use of antidiabetic drugs further increased or decreased the risk of adverse events in patients receiving amiodarone therapy. Next, the RORs were adjusted for coadministered antidiabetic drugs using logistic regression analysis.Results: By whole dataset analysis, significant inverse associations were found between metformin and interstitial lung disease (ROR 0.84, 95% confidence interval [CI] 0.79-0.90; IC -0.24, 95% CI -0.33 to -0.15). In the subset data analysis, metformin (ROR 0.62, 95%CI 0.43-0.89; IC -0.63, 95%CI -1.14 to -0.11), sulfonylureas (ROR 0.53, 95%CI 0.32-0.85; IC -0.85, 95%CI -1.53 to -0.17), and dipeptidyl peptidase-4 (DPP-4) inhibitors (ROR 0.25, 95%CI 0.08-0.78; IC -1.66, 95%CI -3.08 to -0.23) were inversely associated with hyperthyroidism. Additionally, metformin (ROR 0.43, 95%CI 0.33-0.57; IC -1.09, 95%CI -1.49 to -0.69), sulfonylureas (ROR 0.64, 95%CI 0.48-0.86; IC -0.59, 95%CI -1.00 to -0.17), and DPP-4 inhibitors (ROR 0.47, 95%CI 0.27-0.81; IC -0.99, 95%CI -1.76 to -0.22) were inversely associated with interstitial lung disease. In the logistic regression analyses, DPP-4 inhibitors (adjusted ROR 0.32, 95% CI 0.10-1.00) and metformin (adjusted ROR 0.46, 95% CI 0.34-0.62) were inversely associated with amiodarone-associated hyperthyroidism and interstitial lung disease, respectively.Conclusion: Metformin is a candidate drug to reduce the risk of amiodarone-induced hyperthyroidism and interstitial lung disease.