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Effect of metformin on incidence, recurrence, and mortality in prostate cancer patients: integrating evidence from real-world studies

Prostate Cancer and Prostatic Diseases (2024)Cite this article

Subjects

Abstract

Purpose

Metformin has been suggested to reduce the risk of cancer. However, previous studies have been inconsistent regarding the relationship between metformin use and the risk of occurrence of prostate cancer (PCa). The purpose of this study was to assess the effect of metformin on clinical outcomes in patients with PCa in a meta-analysis and to explore the possible dose-response relationship.

Methods

A systematic literature search was conducted in 10 electronic databases and 4 registries. The combined relative risks (RRs) were calculated using a random-effects model with 95% confidence interval (CIs) to assess the effect of metformin on the risk of PCa. Relevant subgroup analyses and sensitivity analyses were performed.

Results

The across studies results show that metformin use associated with lower incidence of PCa (RR: 0.82, 95% CI: 0.74–0.91). Metformin use was also found to reduce PCa recurrence, but the results were not statistically significant (RR: 0.97, 95% CI: 0.81–1.15). Metformin use was not associated with PCa mortality (RR: 0.94, 95% CI: 0.81–1.09). The results of subgroup analyses indicated that the type of study was a cohort study and the population came from both Asia and Europe showed that taking metformin reduced the incidence of PCa. A linear correlation was found between the duration of metformin use and its protective effect.

Conclusions

This meta-analysis revealed an independent correlation between metformin use and reduced incidence of PCa. Metformin use was not associated with either PCa recurrence rate or mortality. Furthermore, the effect of metformin on PCa incidence was found to be related to duration.

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Fig. 1: PRISMA flow diagram of search strategy.
Fig. 2: Metformin use on PCa risk of incidence.
Fig. 3: Metformin use on PCa risk of recurrence.
Fig. 4: Metformin use on PCa risk of mortality.
Fig. 5: Dose-response analysis of duration of metformin use and risk of PCa.

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Data availability

The data utilized in this study was sourced exclusively from published RWS, all of which are comprehensively presented within this article (including its supplementary information files).

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Acknowledgements

We appreciate support from the Nanchang University Queen Mary School and Nanchang University.

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Authors and Affiliations

  1. Nanchang University Queen Mary School, Nanchang, Jiangxi, PR China

    Yuchen Liu & Qingfang Zhang

  2. Institute of Translational Medicine, Nanchang University, Nanchang, Jiangxi, PR China

    Xuan Huang

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Yuchen Liu and Xuan Huang designed research; Yuchen Liu, Qingfang Zhang, and Xuan Huang conducted literature search; Yuchen Liu participated and assisted in literature search and data collection; Yuchen Liu and Qingfang Zhang analyzed and interpreted data; and Yuchen Liu wrote the paper. Xuan Huang and Qingfang Zhang provided critical opinion. Yuchen Liu, Qingfang Zhang, and Xuan Huang revised the paper. Yuchen Liu had primary responsibility for final content. Xuan Huang is the corresponding authors. All authors read and approved the final manuscript. Guarantor of the article: Xuan Huang. The authors are responsible for the reported research, and have participated in the concept and design, analysis and interpretation of data, drafting or revising of the manuscript, and have approved the manuscript as submitted.

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Liu, Y., Zhang, Q. & Huang, X. Effect of metformin on incidence, recurrence, and mortality in prostate cancer patients: integrating evidence from real-world studies. Prostate Cancer Prostatic Dis (2024). https://doi.org/10.1038/s41391-024-00871-7

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