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Source: Latest Medical News   Dec 04, 2020  2 years, 9 months, 4 weeks, 15 hours, 18 minutes ago

Latest Medical News Reports That Metformin Can Drastically Reduce COVID-19 Mortality Risks In Women

Latest Medical News Reports That Metformin Can Drastically Reduce COVID-19 Mortality Risks In Women
Source: Latest Medical News   Dec 04, 2020  2 years, 9 months, 4 weeks, 15 hours, 18 minutes ago
The latest medical news circulating around is based on a new study by researchers from the University of Minnesota Medical School and UnitedHealth Group-Florida in which it was found that metformin was associated with significantly reduced COVID-19 death risks in women in one of the world's largest observational studies of COVID-19 patients.

According to the study, type 2 diabetes and obesity, as states of chronic inflammation, are risk factors for severe COVID-19. Metformin has cytokine-reducing and sex-specific immunomodulatory effects. Our aim was to identify whether metformin reduced COVID-19-related mortality and whether sex-specific interactions exist.
In this retrospective cohort analysis, the study team assessed de-identified claims data from UnitedHealth Group (UHG)'s Clinical Discovery Claims Database. Patient data were eligible for inclusion if they were aged 18 years or older; had type 2 diabetes or obesity (defined based on claims); at least 6 months of continuous enrolment in 2019; and admission to hospital for COVID-19 confirmed by PCR, manual chart review by UHG, or reported from the hospital to UHG. The primary outcome was in-hospital mortality from COVID-19. The independent variable of interest was home metformin use, defined as more than 90 days of claims during the year before admission to hospital. Covariates were comorbidities, medications, demographics, and state. Heterogeneity of effect was assessed by sex. For the Cox proportional hazards, censoring was done on the basis of claims made after admission to hospital up to June 7, 2020, with a best outcome approach. Propensity-matched mixed-effects logistic regression was done, stratified by metformin use.
It was found that 6256 of the 15 380 individuals with pharmacy claims data from Jan 1 to June 7, 2020 were eligible for inclusion. 3302 (52·8%) of 6256 were women. Metformin use was not associated with significantly decreased mortality in the overall sample of men and women by either Cox proportional hazards stratified model (hazard ratio [HR] 0·887 [95% CI 0·782–1·008]) or propensity matching (odds ratio [OR] 0·912 [95% CI 0·777–1·071], p=0·15).
The study findings showed that metformin was associated with decreased mortality in women by Cox proportional hazards (HR 0·785, 95% CI 0·650–0·951) and propensity matching (OR 0·759, 95% CI 0·601–0·960, p=0·021). There was no significant reduction in mortality among men (HR 0·957, 95% CI 0·82–1·14; p=0·689 by Cox proportional hazards).
The study team concluded that Metformin was significantly associated with reduced mortality in women with obesity or type 2 diabetes who were admitted to hospital for COVID-19.
The research findings were published in the peer reviewed journal: The Lancet Healthy Longevity
The drug metformin is an established, generic medication for managing blood sugar levels in">patients with type 2 diabetes. It also reduces inflammation proteins like TNF-alpha that appear to make COVID-19 worse.
The research is a retrospective cohort analysis based on de-identified patient data from UnitedHealth Group. The team analyzed about 6,000 individuals with type 2 diabetes or obesity who were hospitalized with COVID-19 and assessed whether or not metformin use was associated with decreased mortality.
The study team found an association that women with diabetes or obesity, who were hospitalized for COVID-19 disease and who had filled a 90-day metformin prescription before hospitalization, had a 21% to 24% reduced likelihood of mortality compared to similar women not taking the medication. There was no significant reduction in mortality among men.
Principal investigator Dr Carolyn Bramante, MD, MPH, who is an assistant professor in the Department of Medicine at the University of Minnesota Medical School told Thailand Medical News, "Observational studies like this cannot be conclusive, but contribute to growing bodies of evidence. Seeing a bigger association with protection in women over men may point towards inflammation reduction as a key way that metformin reduces risk from COVID-19. However, more research is needed. A large database covering different geographic areas is rarely available. We were fortunate to have the opportunity to do this research alongside UnitedHealth Group."
Dr Deneen Vojta, MD, Executive Vice President, Enterprise Research and Development, UnitedHealth Group said, “Although effective therapies to mitigate the harm of the SARS-CoV-2 virus are being developed, it is important that we also look to, and evaluate commonly used medications with good safety profiles for their potential to combat the virus."
The study results provide new directions for research against COVID-19. In collaboration with Dr Christopher Tignanelli, MD, assistant professor in the Department of Surgery at the University of Minnesota Medical School, Dr Bramante submitted an investigational new drug application to the Food and Drug Administration for use of metformin for COVID-19 treatment and prevention.
The U.S. FDA approved this application. Dr Bramante and Dr Tignanelli received a donation from the Parsemus Foundation to conduct a multi-site prospective, randomized pilot study in collaboration with the Executive Director of Clinical Research for UnitedHealth Group R&D, Dr Ken Cohen, MD.
This pilot trial will begin enrolling the week of Dec. 8 and will lead into a larger trial that is fully powered for important clinical outcomes if additional funding becomes available. These collaborators are still seeking this funding.
Prospective studies are needed to understand mechanism and causality. If findings are reproducible, metformin could be widely distributed for prevention of COVID-19 mortality, because it is safe and inexpensive.
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