Metformin reduces TB risk in patients with diabetes

  • Zhang M & al.
  • Eur J Clin Pharmacol
  • 30 Nov 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

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