Trial reportCancer prevention research (Philadelphia, Pa.)2015

Metformin use and risk of prostate cancer: results from the REDUCE study.

Tom Feng, Xizi Sun, Lauren E Howard, Adriana C Vidal, Alexis R Gaines, Daniel M Moreira, Ramiro Castro-Santamaria, Gerald L Andriole, Stephen J Freedland

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Cancer prevention research (Philadelphia, Pa.), 2015. The graph read 5 numbers from its abstract, feeding 3 cells of the map, but none could be read as for or against, so it casts no vote. Cited by 14 papers, 2 of them syntheses that pooled it.

5numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 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.

Read, but not usablea number the graph found but could not read as for or against

Adverse events & safetyan association or prognostic statement, not a treatment comparison · t2dfeeds one cell of the map
OR 1.83P = 0.19
After adjusting for various clinical and demographic characteristics, we found that metformin use was not significantly associated with total (OR, 1.19; P = 0.50), low- (OR, 1.01; P = 0.96), or high-grade (OR, 1.83; P = 0.19) prostate cancer diagnosis.
Glycemic controlan association or prognostic statement, not a treatment comparison · t2dfeeds 2 cells of the map
OR 1.02P = 0.95
Likewise, there was no significant association between the use of non-metformin antidiabetic medications and prostate cancer risk in both crude (OR, 1.02; P = 0.95) and multivariable analysis (OR, 0.85; P = 0.56).
Glycemic controlan association or prognostic statement, not a treatment comparison · t2dfeeds 2 cells of the map
OR 0.85P = 0.56
Likewise, there was no significant association between the use of non-metformin antidiabetic medications and prostate cancer risk in both crude (OR, 1.02; P = 0.95) and multivariable analysis (OR, 0.85; P = 0.56).
Adverse events & safetyan association or prognostic statement, not a treatment comparison · t2dfeeds one cell of the map
OR 1.01P = 0.96
After adjusting for various clinical and demographic characteristics, we found that metformin use was not significantly associated with total (OR, 1.19; P = 0.50), low- (OR, 1.01; P = 0.96), or high-grade (OR, 1.83; P = 0.19) prostate cancer diagnosis.
Adverse events & safetyan association or prognostic statement, not a treatment comparison · t2dfeeds one cell of the map
OR 1.19P = 0.50
After adjusting for various clinical and demographic characteristics, we found that metformin use was not significantly associated with total (OR, 1.19; P = 0.50), low- (OR, 1.01; P = 0.96), or high-grade (OR, 1.83; P = 0.19) prostate cancer diagnosis.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Metformin×adverse events & safety

No readable resultOpen on the map →What to test next →

22 readable studies in this cell: 9 favour the treatment, 8 find no difference, 5 favour the comparator.

Belief with this paper
0.27contested · 4 families support, 11 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT017190031,413 enrolled · 2012
Adjusted mean -0.72-0.95 to -0.48
NCT018093271,186 enrolled · 2013
Δ -0.40-0.59 to -0.21
NCT022730501,136 enrolled · 2014
Δ -8.90-13.3 to -4.50
NCT01126580807 enrolled · 2010
Δ -0.22-0.36 to -0.08
NCT01023581784 enrolled · 2009
Δ -0.67-0.96 to -0.37
NCT00386100688 enrolled · 2006
Δ 1.47-14.8 to 20.8
NCT01217073685 enrolled · 2010
Δ 1.00-9.80 to 13.1
NCT01890122647 enrolled · 2013
Δ -0.68-0.89 to -0.47
NCT00727857600 enrolled · 2007
Δ 0.860.51 to 1.22
NCT01958671461 enrolled · 2013
Δ -2.60-13.1 to 8.10
NCT00328172302 enrolled · 2006
Δ -0.85-1.10 to -0.59
NCT01485614200 enrolled · 2012
Δ 2.40-10.0 to 14.9

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

Metformin×glycemic control

No readable resultOpen on the map →What to test next →

40 readable studies in this cell: 41 favour the treatment, 13 find no difference, 7 favour the comparator.

Belief with this paper
0.84replicated · 32 families support, 6 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT017190031,413 enrolled · 2012
Adjusted mean -0.72-0.95 to -0.48
NCT018093271,186 enrolled · 2013
Δ -0.40-0.59 to -0.21
NCT022730501,136 enrolled · 2014
Δ -0.89-1.08 to -0.69
NCT008598981,093 enrolled · 2009
Δ -0.53-0.74 to -0.32
Δ -0.85-43.8 to 26.7
NCT00643851994 enrolled · 2008
Δ -0.86-1.11 to -0.62
NCT01708902876 enrolled · 2012
Δ -1.00-1.23 to -0.78
NCT00676338820 enrolled · 2008
Δ -0.05-0.26 to 0.17
NCT01126580807 enrolled · 2010
Δ -0.22-0.36 to -0.08
NCT01023581784 enrolled · 2009
Δ -0.67-0.96 to -0.37
NCT01076088744 enrolled · 2010
Δ -0.84-1.15 to -0.52
NCT00386100688 enrolled · 2006
Δ -0.49-0.67 to -0.30

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

Other glucose-lowering×glycemic control

No readable resultOpen on the map →What to test next →

8 readable studies in this cell: 5 favour the treatment, 0 find no difference, 3 favour the comparator.

Belief with this paper
0.50contested · 3 families support, 1 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT017093055,570 enrolled · 2012
Δ 0.190.02 to 0.36
NCT050350821,018 enrolled · 2021
Δ -0.24-0.44 to -0.04
placebo-subtracted decrease -0.44

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Targeting lipid metabolism in metastatic prostate cancer.Therapeutic advances in medical oncology · 2023
    Review
  6. Review
  7. Article
  8. Review
  9. Article
  10. Prostate Cancer Energetics and Biosynthesis.Advances in experimental medicine and biology · 2019
    Review
  11. Article
  12. Review
  13. Article
  14. Potential role for metformin in urologic oncology.Investigative and clinical urology · 2016
    Review
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

9 authors.

Tom FengDivision of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
Xizi SunSurgery Section, Durham VA Medical Center, Durham, North Carolina. Department of Biostatistics and Bioinformatics, Duke University.
Lauren E HowardSurgery Section, Durham VA Medical Center, Durham, North Carolina. Department of Biostatistics and Bioinformatics, Duke University.
Adriana C VidalDivision of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
Alexis R GainesDivision of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
Daniel M MoreiraDepartment of Urology, Mayo Clinic, Rochester, Minnesota.
Ramiro Castro-SantamariaGlaxoSmithKline Inc., R&D, King of Prussia, Pennsylvania.
Gerald L AndrioleWashington University School of Medicine in St. Louis, St. Louis, Missouri.
Stephen J FreedlandDivision of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California. Surgery Section, Durham VA Medical Center, Durham, North Carolina. Stephen.Freedland@cshs.org.

Funding

NCI NIH HHS K24 CA160653NCI NIH HHS K24CA160653
8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

The role of metformin in prostate cancer chemoprevention remains unclear. REDUCE, which followed biopsy-negative men with protocol-dictated PSA-independent biopsies at 2- and 4-years, provides an opportunity to evaluate the link between metformin use and prostate cancer diagnosis with minimal confounding from screening biases. In diabetic men from REDUCE, we tested the association between metformin use, use of other antidiabetic medications, versus no antidiabetic medication use, and prostate cancer diagnosis as well as prostate cancer grade (low-grade Gleason 4-6 and high-grade Gleason 7-10) using logistic regression. Of the 540 diabetic men with complete data, 205 (38%) did not report use of any antidiabetic medications, 141 (26%) reported use of at least one antidiabetic medication other than metformin, and 194 (36%) reported use of metformin. During the 4-year study, 122 men (23%) were diagnosed with prostate cancer. After adjusting for various clinical and demographic characteristics, we found that metformin use was not significantly associated with total (OR, 1.19; P = 0.50), low- (OR, 1.01; P = 0.96), or high-grade (OR, 1.83; P = 0.19) prostate cancer diagnosis. Likewise, there was no significant association between the use of non-metformin antidiabetic medications and prostate cancer risk in both crude (OR, 1.02; P = 0.95) and multivariable analysis (OR, 0.85; P = 0.56). Furthermore, the interactions between antidiabetic medication use and BMI, geographic location, coronary artery disease, smoking, and treatment group were not significant (all P > 0.05). Among diabetic men with a negative prestudy biopsy who all underwent biopsies largely independent of PSA, metformin use was not associated with reduced risk of prostate cancer diagnosis.

Indexed as

AgedBiopsyDiabetes MellitusDouble-Blind MethodHumansHypoglycemic AgentsMaleMetforminMiddle AgedMultivariate AnalysisNeoplasm GradingOdds RatioProstateProstate-Specific AntigenProstatic NeoplasmsRisk FactorsHypoglycemic AgentsMetforminProstate-Specific Antigen

Identifiers

PMID26353947
PMCPMC4651624

What Socratic holds

Texttitle and abstract
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.