Evidence map›Paper›PMID 23918942›Full record

ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2013

Metformin use and all-cause and prostate cancer-specific mortality among men with diabetes.

David Margel, David R Urbach, Lorraine L Lipscombe, Chaim M Bell, Girish Kulkarni, Peter C Austin, Neil Fleshner

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03031821 (A Randomized Phase 3 Trial of Metformin in Patients Initiating Androgen Deprivation Therapy as Prevention and Intervention of Metabolic Syndrome), which is not on this map. Cited by 139 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
139citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03031821 phase3terminatedstarted 2018, after this paper: background citation

A Randomized Phase 3 Trial of Metformin in Patients Initiating Androgen Deprivation Therapy as Prevention and Intervention of Metabolic Syndrome: The Prime Study

Ran2018Enrolled166Registered outcomes30Posted comparisons0ConditionsMetabolic Syndrome, Prostate CancerArmsMetformin, Placebo Oral Tablet
PMID 21933330PMID 20452916PMID 26633628PMID 9742977PMID 25017630PMID 23230096PMID 8569826PMID 25456737PMID 24412228PMID 25536258PMID 15838067PMID 7821128other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

139 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  5. Metformin as an adjuvant treatment for cancer: a systematic review and meta-analysis.Annals of oncology : official journal of the European Society for Medical Oncology · 2016
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  14. Metformin use and risk of prostate cancer: results from the REDUCE study.Cancer prevention research (Philadelphia, Pa.) · 2015 · on this map
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79 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

David MargelPrincess Margaret Hospital, University Health, Toronto, Canada. sdmargel@gmail.com
David R Urbach
Lorraine L Lipscombe
Chaim M Bell
Girish Kulkarni
Peter C Austin
Neil Fleshner

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the association between cumulative duration of metformin use after prostate cancer (PC) diagnosis and all-cause and PC-specific mortality among patients with diabetes. PATIENTS AND

methodsWe used a population-based retrospective cohort design. Data were obtained from several Ontario health care administrative databases. Within a cohort of men older than age 66 years with incident diabetes who subsequently developed PC, we examined the effect of duration of antidiabetic medication exposure after PC diagnosis on all-cause and PC-specific mortality. Crude and adjusted hazard ratios (HRs) were calculated by using a time-varying Cox proportional hazard model to estimate effects.

resultsThe cohort consisted of 3,837 patients. Median age at diagnosis of PC was 75 years (interquartile range [IQR], 72 to 79 years). During a median follow-up of 4.64 years (IQR, 2.7 to 7.1 years), 1,343 (35%) died, and 291 patients (7.6%) died as a result of PC. Cumulative duration of metformin treatment after PC diagnosis was associated with a significant decreased risk of PC-specific and all-cause mortality in a dose-dependent fashion. Adjusted HR for PC-specific mortality was 0.76 (95% CI, 0.64 to 0.89) for each additional 6 months of metformin use. The association with all-cause mortality was also significant but declined over time from an HR of 0.76 in the first 6 months to 0.93 between 24 and 30 months. There was no relationship between cumulative use of other antidiabetic drugs and either outcome.

conclusionIncreased cumulative duration of metformin exposure after PC diagnosis was associated with decreases in both all-cause and PC-specific mortality among diabetic men.

Indexed as

AgedCause of DeathCohort StudiesDiabetes MellitusHumansHypoglycemic AgentsMaleMetforminProstatic NeoplasmsRetrospective StudiesHypoglycemic AgentsMetformin

Identifiers

PMID23918942

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.