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Editor's Correspondence
June 13, 2011

Levels of Evidence Needed for Changing Indications, Contraindications, and Food and Drug Administration Labeling: The Case of Metformin

Author Affiliations

Author Affiliations: Department of Public Health Sciences, School of Public Health (Drs Eurich, Majumdar, McAlister, Tsuyuki, and Johnson), and Department of Medicine, Faculty of Medicine and Dentistry (Drs Majumdar, McAlister, and Tsuyuki), University of Alberta, Edmonton, Alberta, Canada.

Arch Intern Med. 2011;171(11):1042-1043. doi:10.1001/archinternmed.2011.224

We read with interest the article by Roussel et al1 evaluating the use of metformin in patients with diabetes and atherothrombosis. The potential role of metformin in reducing all-cause mortality was first published in 1998.2 Since then, numerous additional observational studies have supported mortality reduction with the use of metformin therapy.3