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