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.

KEYWORDS:

• Data science
• epidemiology
• healthcare claims database
• metformin
• non-infectious uveitis

Acknowledgments

Authors’ Contributions: LS, JHK, and BLV conceived the study. LS, YY, and BLV carried out the analysis. LS, YY, SH, GS, RAH, JHK and BLV contributed to the interpretation of the results. LS and SH wrote the manuscript with input from all authors. All authors provided critical feedback and helped shape the analysis and manuscript. Lucia Sobrin and Brian L. VanderBeek had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Conflicts of interest

Dr. Kempen has served as a consultant for Gilead (Data and Safety Monitoring Committee Chair) Dr. Hubbard has received financial support from Pfizer and Humana. The remaining authors have no conflicts of interest to disclose.

Additional information

Funding

This work was supported by the National Institutes of Health [R21 EY029851]; Sight for Souls; University of Pennsylvania Core Grant for Vision Research [P30 EY001583]; Research to Prevent Blindness.