Safety of Metformin in Psoriasis Patients With Diabetes Mellitus: A 17-Year Population-Based Real-World Cohort Study

J Clin Endocrinol Metab. 2019 Aug 1;104(8):3279-3286. doi: 10.1210/jc.2018-02526.

Abstract

Context: The safety of metformin usage by diabetic psoriasis patients is unclear.

Objective: To investigate the real-world safety of metformin in psoriatic patients with type 2 diabetes mellitus (T2DM).

Design: 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.

Results: 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).

Conclusion: Metformin can be prescribed for diabetic psoriasis patients without safety concerns.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Male
  • Metformin / therapeutic use*
  • Middle Aged
  • Proportional Hazards Models
  • Psoriasis / complications
  • Psoriasis / drug therapy*
  • Retrospective Studies
  • Taiwan
  • Treatment Outcome

Substances

  • Hypoglycemic Agents
  • Metformin