The impact of oral hypoglycemics and statins on outcomes in myelodysplastic syndromes.
Diabetes Mellitus, Type 2
/ drug therapy
Dipeptidyl-Peptidase IV Inhibitors
/ therapeutic use
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/ therapeutic use
Hypoglycemic Agents
/ therapeutic use
Metformin
/ therapeutic use
Myelodysplastic Syndromes
/ complications
Ontario
Prospective Studies
Retrospective Studies
Sulfonylurea Compounds
/ therapeutic use
Treatment Outcome
Dipeptidyl peptidase-4 inhibitor
Metformin
Myelodysplastic syndrome
Statin
Sulfonylurea
Journal
Annals of hematology
ISSN: 1432-0584
Titre abrégé: Ann Hematol
Pays: Germany
ID NLM: 9107334
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
29
11
2021
accepted:
15
02
2022
pubmed:
23
2
2022
medline:
13
4
2022
entrez:
22
2
2022
Statut:
ppublish
Résumé
Observational studies suggest an anti-neoplastic effect associated with statins, metformin, and dipeptidyl peptidase-4 inhibitors (DPP4i), while sulfonylureas may have a neutral or detrimental effect. We linked the Ontario subset of a prospective Canadian myelodysplastic syndromes (MDS) registry with provincial administrative databases. We assessed the impact of statin/oral hypoglycemic medication exposure on overall survival (OS) using Cox regression analysis, controlling for comorbidities and sociodemographic factors. Five hundred thirty-three patients aged ≥ 66 years were included: 49.3% used statins, 18.9% used metformin, 9.0% used sulfonylureas, and 6.4% used DPP4i. Three hundred ninety-five patients were lower-risk based on the International Prognostic Scoring System. On univariate analysis, we identified a marginal improvement in OS in the lower-risk group using DPP4i (HR 0.98, 95% CI 0.95-1.00, P = 0.05), while there was no impact on mortality for higher-risk DPP4i users (HR 1.03, CI 0.99-1.07, P = 0.21). There was no mortality difference for statins (HR 1.00, CI 1.00-1.01, P = 0.93), metformin (HR 1.00, CI 0.99-1.01, P = 0.81), or sulfonylureas (HR 1.00, CI 0.99-1.02, P = 0.43) in the entire cohort, as well as when stratified into lower/higher-risk groups. On multivariable analysis in the lower-risk group, there was no association between DPP4i and OS (HR 0.98, CI 0.95-1.00, P = 0.06). Prospective studies with larger cohorts of patients and longer follow-up are required to further study the impact of DPP4i in MDS.
Identifiants
pubmed: 35190844
doi: 10.1007/s00277-022-04802-1
pii: 10.1007/s00277-022-04802-1
doi:
Substances chimiques
Dipeptidyl-Peptidase IV Inhibitors
0
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Hypoglycemic Agents
0
Sulfonylurea Compounds
0
Metformin
9100L32L2N
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1023-1030Subventions
Organisme : Ontario Institute for Cancer Research
ID : P.HSR.134
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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