PMID- 35714677 OWN - NLM STAT- MEDLINE DCOM- 20220621 LR - 20220725 IS - 1540-1413 (Electronic) IS - 1540-1405 (Linking) VI - 20 IP - 6 DP - 2022 Jun TI - Risk of New-Onset Prostate Cancer for Metformin Versus Sulfonylurea Use in Type 2 Diabetes Mellitus: A Propensity Score-Matched Study. PG - 674-682.e15 LID - jnccn21495 [pii] LID - 10.6004/jnccn.2022.7010 [doi] AB - BACKGROUND: The aim of this study was to compare the risks of new-onset prostate cancer between metformin and sulfonylurea users with type 2 diabetes mellitus (T2DM). METHODS: This population-based retrospective cohort study included male patients with T2DM presenting to public hospitals/clinics in Hong Kong between January 1, 2000, and December 31, 2009. We only included patients prescribed either, but not both, metformin or sulfonylurea. All patients were followed up until December 31, 2019. The primary outcome was new-onset prostate cancer and the secondary outcome was all-cause mortality. One-to-one propensity score matching was performed between metformin and sulfonylurea users based on demographics, comorbidities, antidiabetic and cardiovascular medications, fasting blood glucose level, and hemoglobin A1c level. Subgroup analyses based on age and use of androgen deprivation therapy were performed. RESULTS: The final study cohort consisted of 25,695 metformin users (mean [SD] age, 65.2 [11.8] years) and 25,695 matched sulfonylurea users (mean [SD] age, 65.3 [11.8] years) with a median follow-up duration of 119.6 months (interquartile range, 91.7-139.6 months) after 1:1 propensity score matching of 66,411 patients. Metformin users had lower risks of new-onset prostate cancer (hazard ratio, 0.80; 95% CI, 0.69-0.93; P=.0031) and all-cause mortality (hazard ratio, 0.89; 95% CI, 0.86-0.92; P<.0001) than sulfonylurea users. Metformin use was more protective against prostate cancer but less protective against all-cause mortality in patients aged <65 years (P for trend <.0001 for both) compared with patients aged >/=65 years. Metformin users had lower risk of all-cause mortality than sulfonylurea users, regardless of the use of androgen deprivation therapy (P for trend <.0001) among patients who developed prostate cancer. CONCLUSIONS: Metformin use was associated with significantly lower risks of new-onset prostate cancer and all-cause mortality than sulfonylurea use in male patients with T2DM. FAU - Lee, Yan Hiu Athena AU - Lee YHA AD - Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China-UK Collaboration. FAU - Zhou, Jiandong AU - Zhou J AD - School of Data Science, City University of Hong Kong, Hong Kong, China. AD - Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom. FAU - Hui, Jeremy Man Ho AU - Hui JMH AD - Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China-UK Collaboration. AD - Department of Medicine, School of Clinical Medicine, University of Hong Kong, Hong Kong, China. FAU - Liu, Xuejin AU - Liu X AD - School of Educational Science, Kaili University, Kaili City, Guizhou, China. FAU - Lee, Teddy Tai Loy AU - Lee TTL AD - Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China-UK Collaboration. AD - Department of Emergency Medicine, School of Clinical Medicine, University of Hong Kong, Hong Kong, China. FAU - Hui, Kyle AU - Hui K AD - Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China-UK Collaboration. FAU - Chan, Jeffrey Shi Kai AU - Chan JSK AD - Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China-UK Collaboration. FAU - Wai, Abraham Ka Chung AU - Wai AKC AD - Department of Emergency Medicine, School of Clinical Medicine, University of Hong Kong, Hong Kong, China. FAU - Wong, Wing Tak AU - Wong WT AD - School of Life Sciences, Chinese University of Hong Kong, Hong Kong, China. FAU - Liu, Tong AU - Liu T AD - Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China. FAU - Ng, Kenrick AU - Ng K AD - Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom. FAU - Lee, Sharen AU - Lee S AD - Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China-UK Collaboration. FAU - Dee, Edward Christopher AU - Dee EC AD - Harvard Medical School, Boston, Massachusetts; and. FAU - Zhang, Qingpeng AU - Zhang Q AD - School of Data Science, City University of Hong Kong, Hong Kong, China. FAU - Tse, Gary AU - Tse G AD - Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China-UK Collaboration. AD - Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China. AD - Kent and Medway Medical School, Canterbury, Kent, United Kingdom. LA - eng PT - Journal Article PL - United States TA - J Natl Compr Canc Netw JT - Journal of the National Comprehensive Cancer Network : JNCCN JID - 101162515 RN - 0 (Androgen Antagonists) RN - 0 (Androgens) RN - 0 (Sulfonylurea Compounds) RN - 9100L32L2N (Metformin) SB - IM MH - Aged MH - Androgen Antagonists/therapeutic use MH - Androgens/therapeutic use MH - *Diabetes Mellitus, Type 2/drug therapy/epidemiology MH - Humans MH - Male MH - *Metformin/adverse effects MH - Propensity Score MH - *Prostatic Neoplasms/drug therapy/epidemiology/etiology MH - Retrospective Studies MH - Sulfonylurea Compounds/adverse effects EDAT- 2022/06/18 06:00 MHDA- 2022/06/22 06:00 CRDT- 2022/06/17 19:13 PHST- 2021/09/22 00:00 [received] PHST- 2022/02/23 00:00 [accepted] PHST- 2022/06/17 19:13 [entrez] PHST- 2022/06/18 06:00 [pubmed] PHST- 2022/06/22 06:00 [medline] AID - jnccn21495 [pii] AID - 10.6004/jnccn.2022.7010 [doi] PST - ppublish SO - J Natl Compr Canc Netw. 2022 Jun;20(6):674-682.e15. doi: 10.6004/jnccn.2022.7010.