Relationship of Glycemia to Cardiovascular Disease ... - Lipids Online

Non–UKPDS Trials:
Metformin vs. Other Interventions
RR (Fixed) 95% CI
Study
All-cause mortality
DeFronzo 1995
Horton 2000
Subtotal (95% CI)
MET
n/N
1/210
1/178
388
Favours
Comparison Metformin
0/209
0/172
381
Favours Weight
Comparison (%)
49.6
50.4
100.0
RR (fixed)
95% CI
2.99 [0.12, 72.88]
2.90 [0.12, 70.69]
2.94 [0.31, 28.16]
Ischemic heart disease
DeFronzo 1995
1/210
0/209
25.2
2.99 [0.12, 72.88]
Hallsten 2002
1/13
0/14
24.2
3.21 [0.14, 72.55]
Horton 2000
1/178
0/172
25.5
2.90 [0.12, 70.69]
Teupe 1991
1/50
0/50
25.1
3.00 [0.13, 71.92]
Subtotal (95% CI)
451
445
100.0
3.02 [0.62, 14.75]
0.01 0.1 1 10 100
CI = confidence interval; MET = metformin; RR = relative risk;
UKPDS = United Kingdom Prospective Diabetes Study
Reprinted from Saenz A, et al. Cochrane Database Syst Rev.
2005;(3):CD002966, with permission from Wiley.
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Non–UKPDS Trials: Metformin vs. Other Interventions
When one looks at metformin data in studies outside of the United Kingdom Prospective
Diabetes Study, however, there apparently is no evidence of cardiovascular benefit, as in
this meta-analysis conducted by Saenz et al. (2005). Furthermore, these other studies tend
to have small numbers of patients.
Reference:
Saenz A, Fernandez-Esteban I, Mataix A, Ausejo M, Roque M, Moher D. Metformin
monotherapy for type 2 diabetes mellitus. Cochrane Database Syst Rev.
2005;(3):CD002966.
Non–UKPDS Trials:
Metformin vs. Conventional Treatment
RR (Fixed) 95% CI
UKPDS
Any diabetes-related
outcomes
MET
n/N
98/342
Conventional Favours
n/N metformin
160/411
Favours Weight
comparison (%)
100.0
RR (fixed)
95% CI
0.74 [0.60, 0.90]
Diabetes-related
death
28/342
55/411
100.0
0.61 [0.40, 0.94]
All-cause mortality
50/342
89/411
100.0
0.68 [0.49, 0.93]
Myocardial infarction
39/342
73/411
100.0
0.64 [0.45, 0.92]
Stroke
12/342
23/411
100.0
0.63 [0.32, 1.24]
Peripheral vascular
disease
6/342
9/411
100.0
0.80 [0.29, 2.23]
Microvascular
24/342
38/411
100.0
0.76 [0.46, 1.24]
0.2 0.5 1 2 5
CI = confidence interval; MET = metformin; RR = relative risk;
UKPDS = United Kingdom Prospective Diabetes Study
Reprinted from Saenz A, et al. Cochrane Database Syst Rev.
2005;(3):CD002966, with permission from Wiley.
Slide Source
Lipids Online Slide Library
www.lipidsonline.org
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