ArticleJournal of the American Society of Nephrology : JASN2020
The FDA Metformin Label Change and Racial and Sex Disparities in Metformin Prescription among Patients with CKD.
Article in Journal of the American Society of Nephrology : JASN, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Type 2 diabetes mellitus and cancer: A systematic review and meta-analysis of Mendelian randomization studies.Frontiers in endocrinology · 2026Pooled it
- Mendelian randomization studies of risk and protective factors for osteoporosis: a systematic review and meta-analysis.Frontiers in endocrinology · 2024Pooled it
- Metformin attenuates diabetic osteoporosis by suppressing ferroptosis via the AMPK/Nrf2 pathway.Frontiers in pharmacology · 2025Article
- Current approaches for management of gastric varices in the United States: a survey of providers' attitudes and practices.Proceedings (Baylor University. Medical Center) · 2025Article
- Challenges in renally eliminated medication use: Evaluating cystatin C and serum creatinine eGFR discordance.Pharmacotherapy · 2024Article
- Metformin treatment reduces the incidence of osteoporosis: a two-sample Mendelian randomized study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- Trends in the prevalence of Chronic Kidney Disease in the United States, 1999-2018.Frontiers in medicine · 2024Article
- Implications of endoplasmic reticulum stress and autophagy in aging and cardiovascular diseases.Frontiers in pharmacology · 2024Review
- Estimating glomerular filtration rate with new equations: can one size ever fit all?Critical reviews in clinical laboratory sciences · 2023Review
- Using measures of race to make clinical predictions: Decision making, patient health, and fairness.Proceedings of the National Academy of Sciences of the United States of America · 2023Article
- Use of Race in Kidney Function Estimation: Lessons Learned and the Path Toward Health Justice.Annual review of medicine · 2023Review
- KDOQI US Commentary on the KDIGO 2020 Clinical Practice Guideline for Diabetes Management in CKD.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2022Article
- Metformin: Sex/Gender Differences in Its Uses and Effects-Narrative Review.Medicina (Kaunas, Lithuania) · 2022Review
- Health inequities and the inappropriate use of race in nephrology.Nature reviews. Nephrology · 2022Review
- Metformin for Cardiovascular Protection, Inflammatory Bowel Disease, Osteoporosis, Periodontitis, Polycystic Ovarian Syndrome, Neurodegeneration, Cancer, Inflammation and Senescence: What Is Next?ACS pharmacology & translational science · 2021Review
- New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race.The New England journal of medicine · 2021Article
- Race, Genetic Ancestry, and Estimating Kidney Function in CKD.The New England journal of medicine · 2021Article
- Metformin, chronic nephropathy and lactic acidosis: a multi-faceted issue for the nephrologist.Journal of nephrology · 2021Review
- Reassessing the Inclusion of Race in Diagnosing Kidney Diseases: An Interim Report From the NKF-ASN Task Force.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2021Article
- Reassessing the Inclusion of Race in Diagnosing Kidney Diseases: An Interim Report from the NKF-ASN Task Force.Journal of the American Society of Nephrology : JASN · 2021Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundIn 2016, the Food and Drug Administration (FDA) changed labeling regarding metformin contraindications in patients with diabetes and CKD from using serum creatinine-based thresholds to using eGFR-based thresholds. Because race and sex affect serum creatinine levels independently of GFR, the earlier creatinine-based contraindication may have inadvertently caused racial and sex disparities in metformin prescription among patients with low eGFR.
methodsIn an analysis of 15,946 Black and White primary care patients with diabetes and eGFR≥30 ml/min per 1.73 m
resultsIn the primary cohort, before the label change, Black patients with eGFR of 30-44 ml/min per 1.73 m
conclusionsThe metformin label change to an eGFR-based contraindication may have reduced racial and sex disparities in metformin prescription in moderate kidney dysfunction.
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Registered trials
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.