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People who use metformin, a common diabetes medication, are less likely to develop myeloproliferative neoplasms (MPNs) over time, according to a recent study published in Blood Advances. This finding suggests that metformin may help prevent the development of certain types of cancers.
Metformin, widely used to manage high blood sugar in people with type 2 diabetes, enhances the effect of insulin, reduces glucose release from the liver, and aids glucose absorption by the body. Previous studies have linked metformin with a reduced risk of various cancers, including gastrointestinal, breast, and urologic cancers. Additionally, a retrospective study of U.S. veterans found a reduced risk of both solid and hematological cancers among metformin users.
“Our team was interested in understanding what other effects we see with commonly prescribed treatments like metformin,” said Anne Stidsholt Roug, MD, PhD, chief physician at Aarhus University Hospital and clinical associate professor at Aalborg University Hospital in Denmark. “The anti-inflammatory effect of metformin interested us, as MPNs are very inflammatory diseases. This is the first study to investigate the association between metformin use and risk of MPN.”
MPNs are a group of diseases that affect bone marrow function, leading to an overproduction of red blood cells, white blood cells, or platelets. This overproduction can cause bleeding problems, increase the risk of stroke or heart attack, and result in organ damage.
The study compared metformin use among patients diagnosed with MPNs and a matched population from the Danish general population between 2010 and 2018. Among the 3,816 MPN cases identified, 268 (7.0%) had taken metformin, compared to 8.2% (1,573 out of 19,080) in the control group who had taken metformin but were not diagnosed with MPN. Only 1.1% of MPN cases had taken metformin for more than five years, compared to 2.0% of controls. The protective effect of metformin was observed across all MPN subtypes when adjusting for potential confounders.
“We were surprised by the magnitude of the association we saw in the data,” said Daniel Tuyet Kristensen, MD, PhD student at Aalborg University Hospital and lead author of the study. “We saw the strongest effect in people who had taken metformin for more than five years compared to those who had taken the treatment for less than a year.” Dr. Kristensen added that this finding makes clinical sense, as MPNs are diseases that develop over a long period, similar to other types of cancer.
While the study showed a protective effect of long-term metformin use across all MPN subtypes, it was limited by its registry-based retrospective design. Additionally, the researchers could not account for lifestyle factors that affect cancer risk, such as smoking, obesity, and dietary habits.
Dr. Roug noted that although the exact mechanism by which metformin appears to protect against MPN development remains unclear, the research team hopes additional studies will further explore this relationship. Moving forward, they aim to investigate similar trends in myelodysplastic syndromes and acute myeloid leukemia in population-level data.
