Evidence mapPaperPMID 38749572Full record

ArticleAnnals of the rheumatic diseases2024

Gout risk in adults with pre-diabetes initiating metformin.

Javier Marrugo, Leah M Santacroce, Misti L Paudel, Sho Fukui, Alexander Turchin, Sara K Tedeschi, Daniel H Solomon

Abstract read
In one paragraph

Article in Annals of the rheumatic diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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

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

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
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4 · The record

Corrections and comments

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

5 · Who and what money

Authors and funding

7 authors.

Javier MarrugoDepartment of Medicine, Division of Rheumatology Immunology and Allergy Research, Brigham and Women's Hospital, Boston, Massachusetts, USA javiermarrugo@hms.harvard.edu dsolomon@bwh.harvard.edu.ORCID http://orcid.org/0000-0001-9157-4269
Leah M SantacroceDepartment of Medicine, Division of Rheumatology Immunology and Allergy Research, Brigham and Women's Hospital, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0001-8951-2296
Misti L PaudelDepartment of Medicine, Division of Rheumatology Immunology and Allergy Research, Brigham and Women's Hospital, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0002-8361-0650
Sho FukuiDepartment of Medicine, Division of Rheumatology Immunology and Allergy Research, Brigham and Women's Hospital, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0002-3082-1374
Alexander TurchinHarvard Medical School, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0002-8609-564X
Sara K TedeschiDepartment of Medicine, Division of Rheumatology Immunology and Allergy Research, Brigham and Women's Hospital, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0001-9475-1363
Daniel H SolomonHarvard Medical School, Boston, Massachusetts, USA javiermarrugo@hms.harvard.edu dsolomon@bwh.harvard.edu.ORCID http://orcid.org/0000-0001-8202-5428

Funding

VERITY: Value and Evidence in Rheumatology using bioInformaTics, and advanced analYticsP30AR072577 · BRIGHAM AND WOMEN'S HOSPITAL · 2025 to 2025
$802k
NIAMS NIH HHS P30 AR072577
6 · The paper itself

Abstract

objectiveDespite the strong association between gout and pre-diabetes, the role of metformin in gout among individuals with pre-diabetes remains uncertain. We compared the incidence rates of gout in adults with pre-diabetes starting metformin with those not using antidiabetic treatments.

methodsWe conducted a new-user, propensity score-matched cohort study using electronic health records from an academic health system (2007-2022). Pre-diabetes was defined based on haemoglobin A1c levels. Metformin users were identified and followed from the first metformin prescription date. Non-users of antidiabetic medications were matched to metformin users based on propensity score and the start of follow-up. The primary outcome was incident gout. Cox proportional hazards models estimated the HR for metformin. Linear regression analyses assessed the association between metformin use and changes in serum urate (SU) or C-reactive protein (CRP).

resultsWe identified 25 064 individuals with pre-diabetes and propensity score-matched 1154 metformin initiators to 13 877 non-users. Baseline characteristics were well balanced (all standardised mean differences <0.1). The median follow-up was 3.9 years. The incidence rate of gout per 1000 person-years was lower in metformin users 7.1 (95% CI 5.1 to 10) compared with non-users 9.5 (95% CI 8.8 to 10.2). Metformin initiation was associated with a reduced relative risk of gout (HR 0.68, 95% CI 0.48 to 0.96). No relationship was found between metformin and changes in SU or CRP.

conclusionsMetformin use was associated with a reduced risk of gout among adults with pre-diabetes, suggesting that metformin may be important in lowering gout risk in individuals with pre-diabetes.

Indexed as

GoutHypoglycemic AgentsMetforminPrediabetic StateAdultAgedCohort StudiesC-Reactive ProteinFemaleGlycated HemoglobinHumansIncidenceMaleMiddle AgedPropensity ScoreProportional Hazards ModelsC-Reactive ProteinGlycated HemoglobinHypoglycemic AgentsMetforminUric AcidCrystal arthropathiesGoutIncidence

Identifiers

PMID38749572
PMCPMC11442121

What Socratic holds

Texttitle and abstract
LicenceTDM
Read underepoch 390

Registered trials

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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.