Systematic Review: Metformin, more than a hypoglycemic
DOI:
https://doi.org/10.56294/piii2023142Keywords:
Metformin, off label use, therapeutic use, obesity, polycystic ovary syndrome, CancerAbstract
Background: Metformin is a biguanide-type oral antidiabetic drug used in Type 2 Diabetes Mellitus (DM 2). Different uses of this drug are proposed in different pathologies, but in the 100 years since the drug became known, the only approved application is in DM2. The experience in off-label uses is relevant, but its scientific evidence and conclusions are limited, so the main objective of this systematic review is to investigate, analyze, and evaluate the beneficial uses of this drug for outside its regulated indication. Material and methods: A primary search was performed in MedLine, Embase, Google Scholar, and SCielo. Results: 13 articles were included where the pathologies of Polycystic Ovarian Syndrome (PCOS), Fragile X Syndrome, Hidradenitis Suppurativa, Acne, Psoriasis, Acanthosis Nigricans, Primary Myelofibrosis, Idiopathic Pulmonary Fibrosis, obesity and overweight and its use with antipsychotics were evaluated. Conclusion: The articles show that metformin caused improvement in pathologies such as Hidradenitis Suppurativa, Acanthosis Nigricans, Psoriasis and acne. Metformin works as a weight loss therapy. It is effective as prevention and treatment of weight gain in treatment with antipsychotics.
In PCOS, metformin acts by reducing weight, improves hirsutism, and stimulates ovulation. In IVF and PCOS together with the use of metformin negatively affects pregnancy rates. Metformin does not reverse bone marrow fibrosis in patients with primary myelofibrosis. In the case of Idiopathic Pulmonary Fibrosis, it did not show improvement
References
Faingold MC, Commendatore V, González C, Bragagnolo JC, Sinay I, Lapertosa S, et al. Guías para el tratamiento de la diabetes mellitus tipo 2. Sociedad Argentina de Diabetes. Rev Soc Argent Diabetes. 17 de noviembre de 2016;50(2):64.
Shenfield G. Metformin: myths, misunderstandings and lessons from history. Aust Prescr. 1 de abril de 2013;36(2):38-9.
Spain VV. Metformina [Internet]. Vademecum.es. Vidal Vademecum; 2016 [citado el 23 de octubre de 2022]. Disponible en: https://www.vademecum.es/principios-activosmetformina-a10ba02
Gov.ar. [citado el 23 de octubre de 2022]. Disponible en: http://www.anmat.gov.ar/comunicados/indicaciones_de_medicamentos_fp.pdf
Sung C, Chao T, Lee A, Foulad D, Choi F, Juhasz M, et al. Oral Metformin for Treating Dermatological Diseases: A Systematic Review. J Drugs Dermatol. 1 de agosto de 2020;19(8):713-20.
Islam H, Masud J, Islam YN, Haque FKM. An update on polycystic ovary syndrome: A review of the current state of knowledge in diagnosis, genetic etiology, and emerging treatment options. Womens Health. enero de 2022;18:174550572211179.
Lord JM. Metformin in polycystic ovary syndrome: systematic review and meta-analysis. BMJ. 25 de octubre de 2003;327(7421):951-0.
Hajjar J, Habra MA, Naing A. Metformin: an old drug with new potential. Expert Opin Investig Drugs. diciembre de 2013;22(12):1511-7.
Lv Z, Guo Y. Metformin and Its Benefits for Various Diseases. Front Endocrinol. 16 de abril de 2020;11:191.
Universidad Nacional de Colombia, MorantesCaballero JA, Londoño-Zapata GA, Universidad Nacional de Colombia, Rubio-Rivera M, Universidad Nacional de Colombia, et al. Metformina: más allá del control glucémico. Rev Médicas UIS. 1 de julio de 2017;30(1):5771.
de Silva VA, Suraweera C, Ratnatunga SS, Dayabandara M, Wanniarachchi N, Hanwella R. Metformin in prevention and treatment of antipsychotic induced weight gain: a systematic review and metaanalysis. BMC Psychiatry. diciembre de 2016;16(1):341.
Ruchi Mathur. Insuline Resistance and the use of Metformin: Effects on Body Weight. Bariatric Times. 2011;8(1):10–12
Joud Hajjar, Mouhammed Amir Habra & Aung Naing (2013) Metformin: an old drug with new potential, Expert Opinion on Investigational Drugs, 22:12, 15111517, DOI: 1517/13543784.2013.833604
Saudi Pharm J. 2017 The effect of metformin use on pregnancy rates among polycystic ovary syndrome patients undergoing in vitro fertilization: A retrospectivecohort studySep;25(6):906-910. doi: 1016/j.jsps.2017.02.008. Epub 2017 Feb 14.
Mathur R, Alexander CJ, Yano J, Trivax B, Azziz R. Use of metformin in polycystic ovary syndrome. Am J Obstet Gynecol. diciembre de 2008;199(6):596-609.
de Silva VA, Suraweera C, Ratnatunga SS, Dayabandara M, Wanniarachchi N, Hanwella R. Metformin in prevention and treatment of antipsychotic induced weight gain: a systematic review and metaanalysis. BMC Psychiatry. diciembre de 2016;16(1):341.
Mizuno Y, Suzuki T, Nakagawa A, Yoshida K, Mimura M, Fleischhacker WW, et al. Pharmacological Strategies to Counteract Antipsychotic-Induced Weight Gain and Metabolic Adverse Effects in Schizophrenia: A Systematic Review and Meta-analysis. Schizophr Bull. 1 de noviembre de 2014;40(6):1385-403.
Fontbonne A, Charles MA, Juhan-Vague I, Bard JM, Andre P, Isnard F, et al. The Effect of Metformin on the Metabolic Abnormalities Associated With Upper-Body Fat Distribution. BIGPRO Study Group. Diabetes Care. 1996 Sep 1;19(9):920–6.
Glueck CJ, Fontaine RN, Wang P, Subbiah MTR, Weber K, Illig E, et al. Metformin reduces weight, centripetal obesity, insulin, leptin, and low-density lipoprotein cholesterol in nondiabetic, morbidly obese subjects with body mass index greater than 30. Metabolism - Clinical and Experimental [Internet]. 2001 Jul
Biag HMB, Potter LA, Wilkins V, Afzal S, Rosvall A, Salcedo‐Arellano MJ, et al. Metformin treatment in young children with fragile X syndrome. Molecular Genetics & Genomic Medicine [Internet]. 2019 Sep 14;7(11).
Campos PDM, Pagnano KB, Mancuso RI, Della Via FI, Tinoco ÂC, Assis-Mendonça GR, et al. Final Results of the Fibromet Trial: An Open Label Phase II Study to Evaluate Metformin Effects on Bone Marrow Fibrosis and Disease Progression in Primary Myelofibrosis Patients Blood [Internet]. 2021 Nov 23
Spagnolo P, Kreuter M, Maher TM, Wuyts W, Bonella F, Corte TJ, et al. Metformin Does Not Affect Clinically Relevant Outcomes in Patients with Idiopathic Pulmonary Fibrosis. Respiration [Internet]. 2018 [cited 2023 Jan 20];96(4):314–22.
Tzouvelekis A, Tzilas V, Dassiou M, Bouros D. Metformin in Idiopathic Pulmonary Fibrosis “Seeking the Holy-Grail through Drug-Repositioning.” Respiration. ;96(4):305–7.
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