Evidence map›Metformin × all-cause mortality›PMID 31786617›Full record

SynthesisEuropean journal of clinical pharmacology2020

Impacts of metformin on tuberculosis incidence and clinical outcomes in patients with diabetes: a systematic review and meta-analysis.

Meng Zhang, Jian-Qing He

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of clinical pharmacology, 2020. The graph read 2 numbers from its abstract, feeding 1 cell of the map, but none could be read as for or against, so it casts no vote. It also reports 2 associations that do not count as treatment evidence, such as RR 0.34 (0.20 to 0.57) for all-cause mortality. Cited by 33 papers, 2 of them syntheses that pooled it.

2numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 2 pooled it
4.9field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Read, but not usablea number the graph found but could not read as for or against

All-cause mortalityan association or prognostic statement, not a treatment comparison · t2dfeeds one cell of the map
RR 0.340.20 to 0.57
The pooled analysis showed that metformin use was associated with a significantly lower active TB incidence and mortality among individuals with DM (RR = 0.51; 95% CI, 0.38-0.69, P ⩽ 0.001) and with TB-DM (RR = 0.34; 95% CI, 0.20-0.57, P ⩽ 0.001), respectively.
FeedsMetformin×all-cause mortality
All-cause mortalityan association or prognostic statement, not a treatment comparison · t2dfeeds one cell of the map
RR 0.510.38 to 0.69
The pooled analysis showed that metformin use was associated with a significantly lower active TB incidence and mortality among individuals with DM (RR = 0.51; 95% CI, 0.38-0.69, P ⩽ 0.001) and with TB-DM (RR = 0.34; 95% CI, 0.20-0.57, P ⩽ 0.001), respectively.
FeedsMetformin×all-cause mortality

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Metformin×all-cause mortality

No readable resultOpen on the map →What to test next →

1 readable study in this cell: 0 favour the treatment, 1 find no difference, 0 favour the comparator.

Belief with this paper
0.25no deciding trial · 0 families support, 0 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT000387272,779 enrolled · 1996
HR 0.990.79 to 1.25

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
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  7. Review
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  11. Article
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  13. Review
  14. Article
  15. Review
  16. Recent Advances in Host-Directed Therapies for Tuberculosis and Malaria.Frontiers in cellular and infection microbiology · 2022
    Review
  17. Review
  18. Metformin to decrease COVID-19 severity and mortality: Molecular mechanisms and therapeutic potential.Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2021
    Review
  19. Review
  20. Article
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Meng ZhangDepartment of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, No. 37,Guo Xue Alley, Chengdu, 610041, China.
Jian-Qing HeDepartment of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, No. 37,Guo Xue Alley, Chengdu, 610041, China. Jianqhe@gmail.com.ORCID http://orcid.org/0000-0003-4778-145X
Sichuan University · CN

Funding

National Natural Science Foundation of China 81870015
8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundAccumulating evidence suggested that the use of metformin had more benefits for both prevention and treatment of tuberculosis (TB) than non-metformin use in patients with diabetes mellitus (DM); however, it remains to be fully elucidated on this topic. Thus, we conducted a systematic review and meta-analysis of published studies to determine the association between metformin use and TB in patients with diabetes.

methodsThe MEDLINE, EMBASE, Information Sciences Institute (ISI) Web of Science, and Cochrane CENTRAL databases were searched from their inception to 15 April 2019. Studies that evaluated the use of metformin and TB disease were included. The quality of each study was evaluated through the Newcastle-Ottawa Scale (NOS). For pooled data, the relative risk (RR) and 95% confidence intervals (CIs) were calculated; otherwise, a systematic review.

resultsSeventeen observational studies were included, all of which indicated a low risk of bias according to the NOS. The pooled analysis showed that metformin use was associated with a significantly lower active TB incidence and mortality among individuals with DM (RR = 0.51; 95% CI, 0.38-0.69, P ⩽ 0.001) and with TB-DM (RR = 0.34; 95% CI, 0.20-0.57, P ⩽ 0.001), respectively.

conclusionsThis meta-analysis indicated metformin use is related to benefits in both prevention and treatment outcomes of tuberculosis among patients with diabetes. Prospective clinical trials are needed to confirm these associations.

Indexed as

Diabetes MellitusHumansHypoglycemic AgentsIncidenceMetforminTuberculosisHypoglycemic AgentsMetforminDiabetes mellitusMeta-analysisMetforminSystematic reviewTuberculosis

Identifiers

PMID31786617
OpenAlexW2992154472

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.