Thursday, November 29, 2012

Metformin may protect against hepatocellular carcinoma

Metformin may protect against hepatocellular carcinoma

  • November 29, 2012
BOSTON — Patients taking metformin may be at reduced risk for hepatocellular carcinoma, according to data presented at The Liver Meeting.

Researchers performed a literature review incorporating three cohort and four case-control studies on 11,503 patients with hepatocellular carcinoma (HCC), within a total cohort of 158,371 patients. All studies involved patients exposed to either metformin, thiazolidinediones (TZD) and/or sulfonylureas and either provided RRs or ORs or included sufficient data for them to be calculated.

Across all studies, metformin use was associated with a decreased incidence rate of HCC (unadjusted OR=0.42; 95% CI, 0.24-0.73), with significant heterogeneity (I2=92%, P<.01). TZDs (unadjusted OR=0.50; 95% CI, 0.26-0.98) also were associated with reduced HCC incidence, while sulfonylureas were linked to an increased rate (unadjusted OR=1.46; 95% CI, 1.08-1.97). Investigators also observed significant heterogeneity in TZD and sulfonylurea results (I2=84% for TZD; I2=74% for sulfonylureas, P<.01 for both). Subgroup analysis indicated that all results were more pronounced among the four Western studies than in the three studies of Asian populations, as well as among hospital-based studies compared with population-based studies.

“Metformin did seem to protect against HCC in diabetic patients, although there were some confounding factors,” researcher Preet Paul Singh, MD, Mayo Clinic in Rochester, Minn., told “It’s too early to say what dose of metformin is needed, how long we should do this for or at what time we should start it. There are a lot of other questions that still need to be answered in terms of recommending this widely in application. … But if somebody’s already on metformin, and at risk of getting HCC, you might want to continue them on that medication rather than try and switch them, if you can help it.”

For more information:
Singh S. #513: Oral anti-diabetic agents and the risk of Hepatocellular Cancer: A Systematic Review and Meta-analysis. Presented at: The Liver Meeting 2012; Nov. 9-13, Boston.

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