Relationship between metformin use and mortality in tuberculosis patients with diabetes: a nationwide cohort study

Autor: Eunki Chung, Dawoon Jeong, Jeongha Mok, Doosoo Jeon, Hee-Yeon Kang, Heejin Kim, Heesun Kim, Hongjo Choi, Young Ae Kang
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: The Korean Journal of Internal Medicine, Vol 39, Iss 2, Pp 306-317 (2024)
Druh dokumentu: article
ISSN: 1226-3303
2005-6648
DOI: 10.3904/kjim.2023.303
Popis: Background/Aims To determine whether metformin, which is considered a host-directed therapy for tuberculosis (TB), is effective in improving the prognosis of patients with TB and diabetes mellitus (DM), who have higher mortality than those without DM. Methods This cohort study included patients who were registered as having TB in the National Tuberculosis Surveillance System. The medical and death records of matched patients were obtained from the National Health Information Database and Statistics Korea, respectively, and data from 2011 to 2017 were collected retrospectively. We classified patients according to metformin use among participants who used diabetes drugs for more than 28 days. The primary outcome was all-cause mortality during TB treatment. Double propensity score adjustment was applied to reduce the effects of confounding and multivariable Cox proportional hazard models were used to estimate adjusted hazard ratio (aHR) with 95% confidence interval (CI). Results The all-cause mortality rate during TB treatment was lower (9.5% vs. 12.4%, p < 0.01) in the metformin user group. The hazard of death due to all causes after double propensity score adjustment was also lower in the metformin user group (aHR 0.76, 95% CI 0.67–0.86, p < 0.01). There was no significant difference in mortality between metformin users and non-users for TB-related deaths (p = 0.22); however, there was a significant difference in the non-TB-related deaths (p < 0.01). Conclusions Metformin use in patients with TB–DM co-prevalence is associated with reduced all-cause mortality, suggesting the potential for metformin adjuvant therapy in these patients.
Databáze: Directory of Open Access Journals
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