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Metformin improved overall survival in patients with diabetes, cirrhosis

Patients with diabetes who were diagnosed with cirrhosis had a greater overall survival rate when taking metformin compared with patients who discontinued it, according to data from a recent study.

Lewis R. Roberts, MB, ChB, PhD, division of gastroenterology and hepatology, Mayo Clinic, Rochester, Minn., and colleagues conducted a cohort study of 250 cirrhotic patients (mean age, 61.2 years; 56.8% men) with diabetes who were taking metformin at the time of diagnosis. The patients were divided into two groups; one group continued treatment with metformin (n=172), the others discontinued use (n=78). Of the patients, 73.3% had Child-Turcotte-Pugh class A cirrhosis, and 56.8% developed cirrhosis through nonalcoholic steatohepatitis (NASH).

Lewis R. Roberts

Data indicated that patients who maintained metformin therapy had a higher median overall survival rate compared with those who discontinued it (11.6 years vs. 5.6 years, P<.0001). Five-year and 10-year survival rates also were higher among those who continued metformin (77.5% vs. 53.1% and 55.2% vs. 30.7%, respectively). Among the continuation group, class A cirrhosis patients displayed better liver function (P=.01) and others had lower model for end-stage liver disease scores (P<.001). The continuation of metformin was an independent predictor for better survival (P=.005) and associated with a 57% decrease in mortality risk (HR=0.43; 95% CI, 0.24-0.78). None of the patients developed lactic acidosis during follow-up, according to researchers.

“Our findings strongly suggest that continuation of metformin improves the survival of NASH-related cirrhotic patients with diabetes,” the researchers concluded. “Validation of these results in a larger cohort would support continuation of metformin use in NASH-related cirrhosis.”

Disclosure: The researchers report no relevant financial disclosures.