Osteoarthritis

Development of Osteoarthritis in Adults With Type 2 Diabetes Treated With Metformin vs a Sulfonylurea

JAMA Netw OpenPublished Retrospective cohort study

Main finding · Incident OAResult — go to the resultAdjusted hazard ratio 0.76 95% CI 0.68–0.85

Authors' conclusion

In this cohort study of individuals with diabetes, metformin treatment was associated with a significant reduction in the risk of developing OA compared with sulfonylurea treatment.

Study context

Population
Adults aged 40 years or older with type 2 diabetes and at least 1 year of continuous enrollment, without prior osteoarthritis (OA), inflammatory arthritis or joint replacement; Optum Clinformatics claims data, December 2003 to December 2019propensity-score matched
Participants
20,937 vs 20,937
Exposure
Metformin vs a sulfonylurea in type 2 diabetes
  • Metforminn = 20,937
  • Sulfonylurean = 20,937reference
Outcome
Incident OA and joint replacement
Methodological detailstime-conditional propensity-score matched, prevalent new-user cohort, claims data, Cox proportional hazard models
  • Time-conditional propensity-score matched
  • Prevalent new-user cohort
  • Claims data
  • Cox proportional hazard models

Main finding

Incident OA

Adjusted hazard ratio

0.76

95% CI 0.68–0.85

P < 0.001

Metforminvs Sulfonylurea
aHR 0.76 (95% CI 0.68–0.85); P < 0.001

As reported in the abstract

Observational data: associations, not effects.

Further findings

OutcomeaHR (95% CI)P value
Joint replacement0.80 (0.50–1.27)P = 0.34
Incident OA, sensitivity analysis (only ever metformin vs only ever sulfonylurea)Sensitivity analysis0.77 (0.65–0.90)P < 0.001
Joint replacement, sensitivity analysis (only ever metformin vs only ever sulfonylurea)Sensitivity analysis1.04 (0.60–1.82)P = 0.89

Joint replacement

No significant difference for risk of joint replacement

Original publication

Development of Osteoarthritis in Adults With Type 2 Diabetes Treated With Metformin vs a Sulfonylurea. JAMA Netw Open. Published 1 March 2023. doi:10.1001/jamanetworkopen.2023.3646

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