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Metformin: Potential analgesic?

Smith B, Ang D

Pain medicine (Malden, Mass.), 2015

329 participants

Abstract

OBJECTIVE: To determine the association of self-report use of metformin and pain intensity.

DESIGN: Survey-based cross sectional.

SETTING: Primary care in an academic medical center.

SUBJECTS: Three hundred and twenty nine participants with diabetes.

METHODS: A total of 329 men and women, aged 18-65, completed a phone-based survey. We utilized the Brief Pain Inventory to assess for pain intensity ratings; Leeds Assessment of Neuropathic Symptoms and Signs to screen for neuropathy; and the Personal Health Questionnaire (PHQ8) Depression Scale to assess for depression.

RESULTS: Three hundred and twenty nine diabetics (mean age 54- ± 8-year old) completed the study (162 metformin users, 167 nonusers). Compared with non-users, metformin users were used more often [38% vs 20%, P = 0.001]; had lower mean depression scores [6.8 vs 8.3; P = 0.026] and fewer comorbidities [1.5 vs 1.8, P = 0.022]. Adjusting for those three variables, pain scores were not significantly different between groups. In a subset analyses of those with neuropathic pain (n = 156), there were no differences in pain scores found between groups.

CONCLUSIONS: In a clinic sample of patients with diabetes, the use of metformin at an average dose of 1,432 mg (SD = 596 mg) was not associated with lower pain scores. Given the anti-nociceptive effects of metformin in the animal models of pain, and the relative safety of metformin, future research should evaluate the effect of the higher dose of metformin as a potential…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 329 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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