Metformin does not affect clinically relevant outcomes in patients with idiopathic pulmonary fibrosis

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Title: Metformin does not affect clinically relevant outcomes in patients with idiopathic pulmonary fibrosis
Authors: Spagnolo, P
Kreuter, M
Maher, TM
Wuyts, W
Bonella, F
Corte, TJ
Kopf, S
Weycker, D
Kirchgaessler, K-U
Ryerson, CJ
Item Type: Journal Article
Abstract: BACKGROUND: Diabetes mellitus is a possible risk factor for the development of idiopathic pulmonary fibrosis (IPF), yet the effect of antidiabetic therapy on the course of IPF is unknown. OBJECTIVES: This post hoc analysis assessed the effect of metformin on clinically relevant outcomes in patients with IPF. METHODS: For the primary analysis, patients randomized to placebo (n = 624) in 3 phase 3, double-blind, controlled trials of pirfenidone (CAPACITY [NCT00287716 and NCT00287729]; ASCEND [NCT01366209]) were categorized by baseline metformin use. The primary outcome was disease progression (forced vital capacity [FVC] decline ≥10%, 6-min walking distance [6MWD] decline ≥50 m, or death). Other outcomes included mortality, hospitalization, FVC decline (≥10 and ≥5%), and 6MWD decline. Outcomes were also assessed in patients with diabetes and/or hyperglycemia (impaired glucose tolerance [IGT] and diabetes population [IGT-diabetes population]) and all patients included in the 3 studies (intention-to-treat [ITT] population). RESULTS: Overall, 71 (11.4%) patients were metformin users and 553 (88.6%) were nonmetformin users. Baseline data were similar between groups, except for a higher percentage of males (84.5 vs. 73.2%) and a history of diabetes (98.6 vs. 11.6%) in metformin users versus nonmetformin users. The unadjusted 1-year analyses demonstrated no significant differences in disease progression or other outcomes. A higher proportion of metformin users compared with nonmetformin users had a relative FVC decline of ≥5% (63.4 vs. 50.6%, p = 0.043). Results were similar for the IGT-diabetes population and for the ITT population. Multivariable analyses yielded similar results. CONCLUSIONS: Metformin has no effect on clinically relevant outcomes in patients with IPF.
Issue Date: 1-Oct-2018
Date of Acceptance: 25-Apr-2018
URI: http://hdl.handle.net/10044/1/61298
DOI: https://doi.org/10.1159/000489668
ISSN: 1423-0356
Publisher: Karger Publishers
Start Page: 314
End Page: 322
Journal / Book Title: Respiration
Volume: 96
Issue: 4
Copyright Statement: © 2018 S. Karger AG, Basel
Keywords: Diabetes mellitus
Hyperglycemia
Idiopathic pulmonary fibrosis
Metformin
Post hoc analysis
Diabetes mellitus
Hyperglycemia
Idiopathic pulmonary fibrosis
Metformin
Post hoc analysis
1102 Cardiorespiratory Medicine and Haematology
Respiratory System
Publication Status: Published
Conference Place: Switzerland
Online Publication Date: 2018-07-19
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine



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