The Lancet Sub-Journal: New Uses of Metformin? It is expected to improve metabolic health in patients with chronic inflammation.

Whether metformin, a classic hypoglycemic drug, can "open new flowers in old trees" and open up new indications, has always been a hot topic for people.a study recently published in the lancet diabetes and endocrinology has brought back supporting evidence for potential new uses.in phase 2 clinical trials, metformin can improve metabolic health and reduce the serious side effects of glucocorticoid treatment in patients with chronic inflammatory diseases.source: The Lancet Diabetes & amp; Endocrinology since the discovery of prednisolone and other glucocorticoids in the 1950s, such drugs have greatly changed the treatment options of patients with chronic inflammatory diseases such as rheumatoid arthritis, and have been gradually applied to the treatment of more diseases related to the overactive immune system, such as asthma, chronic obstructive pulmonary disease, etc.however, long-term and high-dose use of these drugs may lead to serious metabolic side effects, including weight gain, increased blood sugar, bone and muscle loss, increased risk of infection and thrombosis.in the long run, this may lead to Cushing's syndrome and even increase the mortality rate.in the previous study, they were from Queen Mary University of London London) research team found that glucocorticoid can affect a key metabolic protein called AMPK. Other experiments have suggested that metformin may act through AMPK protein, and the mechanism of action is exactly opposite to that of glucocorticoid, and it has the potential to reverse the side effects caused by the use of glucocorticoid.Image Source: pixabay based on these studies, the research team of Queen Mary University in London led the phase II clinical trial of this randomized, double-blind, placebo-controlled, proof of concept.the trial was conducted in four hospitals in the United Kingdom. A total of 53 non-diabetic patients aged 18-75 years who received continuous prednisolone treatment from 2012 to 2014 were included.subjects were randomly assigned to receive metformin or placebo at a 1:1 ratio.the course lasted for 12 weeks, and the dose gradually increased: 850 mg once a day for the first five days; 850 mg twice a day for the next five days; and 850 mg three times a day for the next five days.the results showed that patients taking metformin showed better clinical effect. Br / > compared with the placebo group, BG significantly improved the blood glucose and fat metabolism of the patients, but also significantly improved the blood glucose and fat metabolism of the patients.this is also reflected in the overall health status of patients.in patients taking metformin, the incidence of pneumonia (1 case vs. 7 cases), moderate to severe infection (2 cases vs. 11 cases) and hospitalization due to adverse events (1 case vs. 9 cases) were significantly reduced.compared with the placebo group, the metformin group had more diarrhea events (18 cases vs 8 cases).Image Source: Dr. m á RTA korbonites, Professor of endocrinology at Queen Mary University, London, author of the pixabay study, said, "the results of the trial are very positive. Metformin, a simple and immediately available intervention, can improve the health status of patients with glucocorticoids, including treatment-related complications and cardiovascular prognosis."this may have a significant impact on patients who use a large amount of glucocorticoids for a long time. "Dr. korbonites further pointed out that" although biological agents have been used more and more, patients in many parts of the world are still very dependent on glucocorticoids. doctors and patients have been waiting for safe, cheap and effective treatment methods to prevent metabolic complications of these drugs without affecting their anti-inflammatory effects. our results suggest that metformin has the potential to help these patients. "in a commentary accompanying the journal, Dr. Martin Reincke of the University of Munich (LMU), Germany, pointed out that" the excellent effect of metformin on these indicators suggests that we may need to take (further) action immediately. "of course, the current study sample size is small, and the time is short. He also reminded that" it is necessary to prove that metformin does not interfere with the anti-inflammatory and immunosuppressive effects of glucocorticoids. "In this experiment, the patients in the metformin group had less pneumonia," which may indicate that the interaction between the drug and the immune system is complex. ". Dr Reincke pointed out that more large-scale phase 3 trials are needed before clinical practice can be changed. at present, he suggests that "(professional doctors) prescribe metformin only on a case by case basis". it is expected that this trial will continue to bring positive results and bring new options to improve the side effects of glucocorticoids. references (slide up and down) [1] pernicova I, et al. (2020). Metformin to reduce metallic complications and inflammation in patients on systemic glucocorticoid therapy: a random, double blind, placebo controlled, proof of concept, phase 2 trial. Lancet diabetes Endocrinol, DOI: 10.1016/S2213-8587(20)30021-8.[2] Reincke M, et al., (2020). Metformin: the white knight fighting corticosteroid side effects. Lancet Diabetes Endocrinol, DOI: 10.1016/ S2213-8587(20)30040-1.[3] Diabetes drug reduces complications of long-term steroid therapy. Retrieved Feb 26, 2020, From diabetes drug may benefit long term steroid users. Retrieved Feb 26, 2020, from. if you need guidance on treatment plan, please go to a regular hospital.