Program

In-person AND virtual! – We are pioneering a new conference format that will connect in-person and virtual audiences to create a unique experience. Matching the innovation that comes through our members’ work, ISPOR is pushing the boundaries of innovation to design an event that works in today’s quickly changing environment. 

In-person registration included the full virtual experience, and virtual-only attendees will be able to tune into live in-person sessions and/or watch captured in-person sessions on-demand in addition to having a variety of virtual-only sessions to attend.

Metformin Use Is Associated with Reduced Incidence of Invasive Pneumococcal Disease after a Pneumococcal Vaccine in Adults with Type 2 Diabetes: A Retrospective Cohort Study

Speaker(s)

Bandy S1, Black CA2, Anderson A2, Lipscomb J2, Benavides R3, Lee G2
1The University of Texas at Austin, San Antonio, TX, USA, 2The University of Texas at Austin, Austin, TX, USA, 3The University of Texas Health at San Antonio, San Antonio, TX, USA

Presentation Documents

Objective: Metformin, a first-line agent for type 2 diabetes mellitus (T2DM) has been shown to have immunomodulating properties in vaccine efficacy, aging and infections, including pneumonia. This study evaluated whether metformin-use associated with lower risk for invasive pneumococcal disease (IPD) post receipt of a pneumococcal vaccine (PNV).

Methods: This was a retrospective U.S. cohort analysis of a third-party medical and pharmacy claims database from 2009 to 2019. Adults 18 years of age and older who received a PNV and were continuously enrolled for more than 1 year before and after PNV administration were included. Diagnosis of IPD requiring hospitalization was determined using ICD-9/10-CM codes. Metformin-use was defined as more than 90 days of claim with fill within 30 days prior to PNV. Demographics, PNV type/year, medications, and co-morbidities were covariates. Multivariable logistic-regression models were conducted, stratified by metformin-use and T2DM.

Results: Overall, 600,132 adults were included. The median age was 65 years and 45.1% were males. Approximately 24% of individuals with T2DM (n=155,308) were metformin-users compared to 1.6% of those without T2DM (n=444,824). Metformin-use was independently associated with lower risk of IPDs post-PNV (aOR 0.878, 95% CI 0.826-0.933). This protective effect was likely driven by individuals with T2DM using metformin vs. non-users (aOR 0.812, 95% CI 0.760-0.867). In contrast, among those without T2DM, there were no differences in IPD (aOR 0.989, 95%CI 0.852-1.148). The median (IQR) days to event was shorter post-PNV among metformin-users vs. non-users [495 (276-870) vs. 548 (276-1170), p<0.001].

Conclusion: Metformin-use was associated with a reduced risk of IPDs after receiving PNVs, particularly among those with T2DM. These results add to the sparse data highlighting the immunomodulatory effects of metformin and its potential role in vaccine-care, aging and preventative medicine.

Code

EPH29

Topic

Clinical Outcomes, Epidemiology & Public Health

Topic Subcategory

Relating Intermediate to Long-term Outcomes, Safety & Pharmacoepidemiology

Disease

Diabetes/Endocrine/Metabolic Disorders, Drugs, Respiratory-Related Disorders, Vaccines