The FDA Metformin Label Change and Racial and Sex Disparities in Metformin Prescription among Patients with CKD Injury
Abstract
A recent article by Shin et al., entitled “The FDAMetformin Label Change and Racial and Sex Disparities in Metformin Prescription among Patients with CKD Injury,” described how the transition from a creatinine-based threshold for prescribing metformin to an eGFR-based threshold was associated with a reduction in the racial disparity of metformin prescribing for Black patients. Shin et al. found a 25% increase (from 26.1% to32.6%) in prescribing of metformin for Black patients with an eGFR of 30–44 ml/min per 1.73 m. This increase would likely have been less had the eGFR been estimated to be 16% lower for all Black patients by eliminating the Black race coefficient in the CKD– Epidemiology Collaboration equation. Because the nephrology community is undergoing an examination of whether the Black race coefficient for eGFR is appropriate,2,3 and because some medical institutions have already moved to eliminate the Black race coefficient for eGFR, it would be helpful if the authors could analyze the potential effect on their study results of eliminating the Black race coefficient from the eGFR by the CKD–Epidemiology Collaboration equation. DISCLOSURES
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