We considered an CMAJ | December 19, 2022 | Volume 194 | Issue 49 E1673 Research absolute standardized mean difference of less than 0.1 between and 1:1 matching by age, sex and date of first visit for diagnosis the 2 groups after PSM as well balanced.29 of diabetes mellitus using PTDM, 20 347 participants were in We calculated the incidence rates of TKR or THR in the PTDM each of the metformin us. [...] explore the effects of time-varying exposure of metformin after The characteristics of participants at baseline are shown in adjustment for the time-dependent covariates. [...] Furthermore, we conducted the analyses with the Association of metformin use with incidence of total alternative outcome of hospital admission for knee or hip OA joint replacement regardless of the type of treatment. [...] Use of metformin was associated with a lower cumulative inci- To examine the potential dose–response relationship dence probability of TKR, THR or either total joint replacement between metformin use and risk of total joint replacement, we (Figure 2). [...] Metformin has been studied in Despite the multiple strategies that we employed to control patients without diabetes mellitus and was found to be safe.36 Trials for potential confounders, unmeasured confounding factors of metformin for the prevention of diabetes mellitus and for weight could yet bias the results.
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