Dataset Information

Risk of Non-infectious Uveitis with Metformin Therapy in a Large Healthcare Claims Database.

ABSTRACT:

Purpose

To determine if metformin is associated with noninfectious uveitis (NIU).

Methods

Patients in an insurance claims database who initiated metformin (n = 359,139) or other oral anti-diabetic medications (n = 162,847) were followed for NIU development. Both cohort and case-control analyses were performed to assess differing exposure lengths using Cox and conditional logistic regression, respectively.

Results

The hazard ratio (HR) for incident NIU was not significantly different between the metformin and non-metformin cohorts [HR = 1.19, 95% Confidence Interval (CI): 0.92-1.54, P = .19]. The case control analysis similarly showed no association between any metformin use 2 years before the outcome date and NIU [odds ratio (OR) = 0.64, 95% CI: 0.39-1.04, P = .07]. However, there was a protective 20 association between cumulative metformin duration [(445-729 days) adjusted OR (aOR) = 0.49, 95% CI: 0.27-0.90, P = .02] and dosage (>390,000 mg aOR = 0.44, 95% CI: 0.25-0.78, P = .001) compared with no metformin use.

Conclusions

Our results suggest metformin use for longer durations may be protective of NIU onset.

SUBMITTER: Sobrin L

PROVIDER: S-EPMC8423860 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Risk of Non-infectious Uveitis with Metformin Therapy in a Large Healthcare Claims Database.

Sobrin Lucia L Yu Yinxi Y Han Samuel S Susarla Gayatri G Kempen John H JH Hubbard Rebecca A RA VanderBeek Brian L BL

Ocular immunology and inflammation 20210308 6

<h4>Purpose</h4>To determine if metformin is associated with noninfectious uveitis (NIU).<h4>Methods</h4>Patients in an insurance claims database who initiated metformin (n = 359,139) or other oral anti-diabetic medications (n = 162,847) were followed for NIU development. Both cohort and case-control analyses were performed to assess differing exposure lengths using Cox and conditional logistic regression, respectively.<h4>Results</h4>The hazard ratio (HR) for incident NIU was not significantly ...[more]

PMID: 33683184

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Project description:BackgroundFew contemporary US-based long bone non-union analyses have recently been published. Our study was designed to provide a current understanding of non-union risks and costs, from the payers' perspective.MethodsThe Merative™ MarketScan® Commercial Claims and Encounters database was used. Patients with surgically treated long bone (femur, tibia, or humerus) fractures in the inpatient setting, from Q4 2015 to most recent, were identified. Exclusion criteria included polytrauma and amputation at index. The primary outcome was a diagnosis of non-union in the 12 and 24 months post-index. Additional outcomes included concurrent infection, reoperation, and total healthcare costs. Age, gender, comorbidities, fracture characteristics, and severity were identified for all patients. Descriptive analyses were performed. Crude and adjusted rates of non-union (using Poisson regressions with log link) were calculated. Marginal incremental cost of care associated with non-union and infected non-union and reoperation were estimated using a generalized linear model with log link and gamma distribution.ResultsA total of 12,770, 13,504, and 4,805 patients with femoral, tibial, or humeral surgically treated fractures were identified, 74-89% were displaced, and 18-27% were comminuted. Two-year rates of non-union reached 8.5% (8.0%-9.1%), 9.1% (8.6%-9.7%), and 7.2% (6.4%-8.1%) in the femoral, tibial, and humeral fracture cohorts, respectively. Shaft fractures were at increased risk of non-union versus fractures in other sites (risk ratio (RR) in shaft fractures of the femur: 2.36 (1.81-3.04); tibia: 1.95 (1.47-2.57); humerus: 2.02 (1.42-2.87)). Fractures with severe soft tissue trauma (open vs. closed, Gustilo III vs. Gustilo I-II) were also at increased risk for non-union (RR for Gustilo III fracture (vs. closed) for femur: R = 1.96 (1.45-2.58), for tibia: 3.33 (2.85-3.87), RR for open (vs. closed) for humerus: 1.74 (1.30-2.32)). For all fractures, younger patients had a reduced risk of non-union compared to older patients. For tibial fractures, increasing comorbidity (Elixhauser Index 5 or greater) was associated with an increased risk of non-union. The two-year marginal cost of non-union ranged from $33K-$45K. Non-union reoperation added $16K-$34K in incremental costs. Concurrent infection further increased costs by $46K-$86K.ConclusionsNon-union affects 7-10% of surgically treated long bone fracture cases. Shaft and complex fractures were at increased risk for non-union.

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Dataset Information

Risk of Non-infectious Uveitis with Metformin Therapy in a Large Healthcare Claims Database.

Purpose

Methods

Results

Conclusions

Publications

Risk of Non-infectious Uveitis with Metformin Therapy in a Large Healthcare Claims Database.

Similar Datasets

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