Effectiveness of metformin in the management of osteoarthritis in patients with type 2 diabetes
Abstract
Objective: Osteoarthritis (OA) is a frequent comorbidity in patients with type 2 diabetes mellitus (T2DM), significantly affecting health status and quality of life. Emerging evidence suggests metformin, a first-line agent for T2DM, may also have therapeutic effects on OA. This study aimed to evaluate the efficacy of metformin in improving symptoms and reducing the risk of joint replacement in patients with both OA and T2DM through a systematic review and meta-analysis.
Methods: A comprehensive search was conducted across PubMed, Embase, Web of Science, the Cochrane Library, and China National Knowledge Infrastructure (CNKI) for studies published up to June 2025. Eligible studies included randomized controlled trials, cohort studies, and retrospective analyses examining metformin use in patients with OA and T2DM. Data on clinical outcomes-including the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), total knee replacement (TKR), and total hip replacement (THR)-were extracted. Pooled effect sizes were calculated using random-effects models. Subgroup analyses were performed based on study design, metformin dosage, and treatment duration.
Results: Ten studies involving 243,221 participants were included. Metformin use significantly lowered TKR risk (HR = 0.46; 95% CI: 0.30-0.72) and improved pain scores (SMD = -2.04; 95% CI: -2.44 to -1.64). Subgroup analyses revealed that higher daily dosages (≥ 1.0 g/d) and longer treatment…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 243,221 participants or records.
Read the paper
Related studies
- Metformin as an adjuvant in breast cancer treatment
- Metformin Lysosomal Targeting: A Novel Aspect to Be Investigated for Metformin Repurposing in Neurodegenerative Diseases?
- Aberrant HSF1 signaling activation underlies metformin amelioration of myocardial infarction in mice
- Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines
- Protein Interaction Network for Identifying Vascular Response of Metformin (Oral Antidiabetic)
- Preventing Long COVID With Metformin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.