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Clinical Summary

Metformin reduces TB risk in patients with diabetes

Takeaway

  • Metformin (MET) use was associated with lower risk for active tuberculosis (TB) incidence and lower mortality compared with non-MET use in patients with diabetes mellitus (DM) and with TB-DM, respectively.

Why this matters

  • Accumulating evidence suggested that MET use had more benefits for both prevention and treatment of TB than non-MET use in patients with DM.

Study design

  • Meta-analysis included 17 studies that evaluated the association between metformin use and TB in patients with DM, after a search across electronic databases.
  • Funding: The National Natural Science Foundation of China.

Key results

  • MET significantly reduced the incidence of TB in patients with DM (relative risk [RR], 0.51; 95% CI, 0.38-0.69; P=.000; I2, 93.4%) and mortality risk in patients with TB-DM (RR, 0.34; 95% CI, 0.20-0.57;P=.843).
  • The rate of TB recurrence after completion of anti-TB treatment was much lower in MET users vs non-users (9.0% vs 21.2%), however, random-effects model demonstrated no significant effect between the two groups (RR, 0.55; 95% CI, 0.07-4.525; P=.58; I2, 69.1%).
  • The blood lactate levels did not differ after at least 2 months of MET therapy (P>.05) and were in the normal range (>2.50 mmol/L) in both MET and non-MET groups.

Limitation

  • No analysis of a dose–response relationship.
  • Risk of bias

References


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