Dataset Information

Metformin use and respiratory outcomes in asthma-COPD overlap.

ABSTRACT:

Background

Metformin is associated with improved respiratory outcomes in asthma; however, metformin in COPD and asthma-COPD overlap (ACO) remains unexplored.

Objective

To determine the association between metformin use and respiratory outcomes in COPD and ACO.

Study design and methods

Participants with COPD (FEV1/FVC < 0.70) in the Genetic Epidemiology of COPD study (COPDGene®) were categorized as ACO (n = 510), defined as concurrent physician-diagnosed asthma before age 40 years, or COPD alone (n = 3459). We estimated the association of baseline metformin use with (1) rate of total and severe respiratory exacerbations during follow-up, (2) cross-sectional St. George's Respiratory Questionnaire (SGRQ) score, six-minute walk distance (6MWD), and post-bronchodilator FEV1 percent predicted (FEV1pp), and (3) 5-year change in SGRQ, 6MWD, and FEV1pp. We also examined change in SGRQ, 6MWD and FEV1pp among participants who initiated metformin during follow-up (n = 108) compared to persistent metformin non-users (n = 2080). Analyses were adjusted for sociodemographic factors, medications, and comorbidities.

Results

Among participants with ACO, metformin use was associated with lower rate of total (adjusted incidence rate ratio [aIRR] 0.3; 95% confidence interval [95%CI] 0.11, 0.77) and severe exacerbations (aIRR 0.29; 95%CI 0.10, 0.89). Among participants with COPD alone, there was no association between metformin use with total (aIRR 0.98; 95%CI 0.62, 1.5) or severe exacerbations (aIRR 1.3; 95% CI 0.68, 2.4) (p-interaction < 0.05). Metformin use was associated with lower baseline SGRQ score (adjusted mean difference [aMD] - 2.7; 95%CI - 5.3, - 0.2) overall. Metformin initiation was associated with improved SGRQ score (aMD -10.0; 95% CI - 18.7, - 1.2) among participants with ACO but not COPD alone (p-interaction < 0.05). There was no association between metformin use and 6MWD or FEV1pp in any comparison.

Conclusions

Metformin use was associated with fewer respiratory exacerbations and improved quality of life among individuals with ACO but not COPD alone. Results suggest a potential role for metformin in ACO which requires further prospective study.

Trial registry

NCT00608764.

SUBMITTER: Wu TD

PROVIDER: S-EPMC7908718 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Metformin use and respiratory outcomes in asthma-COPD overlap.

Wu Tianshi David TD Fawzy Ashraf A Kinney Gregory L GL Bon Jessica J Neupane Maniraj M Tejwani Vickram V Hansel Nadia N NN Wise Robert A RA Putcha Nirupama N McCormack Meredith C MC

Respiratory research 20210226 1

<h4>Background</h4>Metformin is associated with improved respiratory outcomes in asthma; however, metformin in COPD and asthma-COPD overlap (ACO) remains unexplored.<h4>Objective</h4>To determine the association between metformin use and respiratory outcomes in COPD and ACO.<h4>Study design and methods</h4>Participants with COPD (FEV1/FVC < 0.70) in the Genetic Epidemiology of COPD study (COPDGene®) were categorized as ACO (n = 510), defined as concurrent physician-diagnosed asthma before age 40 ...[more]

PMID: 33637087

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Dataset Information

Metformin use and respiratory outcomes in asthma-COPD overlap.

Background

Objective

Study design and methods

Results

Conclusions

Trial registry

Publications

Metformin use and respiratory outcomes in asthma-COPD overlap.

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