Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
J Clin Endocrinol Metab. 2019 Aug 1;104(8):3279-3286. doi: 10.1210/jc.2018-02526.
The safety of metformin usage by diabetic psoriasis patients is unclear.
To investigate the real-world safety of metformin in psoriatic patients with type 2 diabetes mellitus (T2DM).
We used the National Health Insurance Research Database to perform a cohort study. Based on metformin and other antidiabetic agent prescriptions, we divided all psoriasis patients with T2DM into the metformin group and the nonmetformin group. The outcomes included all-cause mortality, severe psoriasis, hospitalization due to psoriasis, and any cause for readmission.
The metformin group (n = 5520) and the nonmetformin group (n = 3062) did not significantly differ in the risk of all-cause mortality [hazard ratio (HR) 1.08; 95% CI, 0.90 to 1.30], severe psoriasis (HR, 0.95; 95% CI, 0.80 to 1.09), psoriasis-related admission (HR, 1.32; 95% CI, 0.90 to 1.93), and any-cause readmission (HR, 0.99; 95% CI, 0.90 to 1.11). The dose-response analysis found no significant increase in the risk of severe psoriasis and psoriasis-related admission, even with more than 80 defined daily doses or 1000 mg daily dose of metformin prescribed (P for linear trend > 0.05).
Metformin can be prescribed for diabetic psoriasis patients without safety concerns.
糖尿病合并银屑病患者使用二甲双胍的安全性尚不清楚。
调查真实世界中 2 型糖尿病合并银屑病患者使用二甲双胍的安全性。
我们使用国家健康保险研究数据库进行了一项队列研究。根据二甲双胍和其他降糖药物的处方，我们将所有 2 型糖尿病合并银屑病的患者分为二甲双胍组和非二甲双胍组。结局包括全因死亡率、严重银屑病、因银屑病住院以及任何原因再入院。
二甲双胍组（n = 5520）和非二甲双胍组（n = 3062）在全因死亡率[风险比（HR）1.08；95%置信区间（CI）0.90 至 1.30]、严重银屑病（HR，0.95；95%CI，0.80 至 1.09）、银屑病相关住院（HR，1.32；95%CI，0.90 至 1.93）和任何原因再入院（HR，0.99；95%CI，0.90 至 1.11）方面的风险无显著差异。剂量反应分析发现，即使处方超过 80 个定义日剂量或每天 1000mg 二甲双胍，严重银屑病和银屑病相关住院的风险也没有显著增加（P 趋势>0.05）。
二甲双胍可用于糖尿病合并银屑病患者，且无安全性问题。
