Researchers investigated the relationship between frequent metformin use and total knee replacement in patients with diabetes. In this retrospective study using computerized records of Hong Kong public primary care, 45-year-old diabetic patients enrolled from 2007 to 2010 were followed for four years from 2011 to 2014 to determine the incidence of total knee replacement.
Knee osteoarthritis is the most common type of chronic arthritis and a leading cause of pain and disability worldwide. According to the Global Burden of Disease study, the global age-standardized point prevalence and annual incidence rate of osteoarthritis in 2017 were 3754.2 and 181.2 per 100,000 people, respectively. Individuals with knee OA experience increased pain, activity limitations, psychological distress, and significantly lower quality of life (
Among 46,665 frequent users, there were 184 total knee replacements, 17.1% less than nonusers.
The Relationship Between Metformin and Osteoarthritis
The findings suggest a potential preventive effect of metformin on the development of knee osteoarthritis and subsequent total knee replacement among diabetic patients. Osteoarthritis is a common chronic disease that usually causes joint discomfort and can be severe enough to require knee and hip replacement. Total knee and total hip replacement surgeries in the United States are expected to reach 5,72,000 annually by 2030. There are currently no medications that can prevent or reverse osteoarthritis.
A team of researchers from China, Taiwan and Australia set out to test whether metformin use was associated with a lower risk of total knee or total hip replacement, as the evidence had so far been sparse and inconclusive. They compared the risk of total knee and/or total hip replacement between metformin users and nonusers in 69,706 Taiwanese people diagnosed with type 2 diabetes between 2000 and 2012. The mean age was 63 and half of the participants were women. Osteoarthritis was responsible for almost 90% of total joint replacements (2✔ ✔Reliable Source
Metformin use and risk of total knee replacement among diabetic patients: a propensity-score-matched retrospective cohort study
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Zhujiang Hospital Clinical Research Center employee Dr. “We found that metformin use in patients with type 2 diabetes was associated with a significantly reduced risk of joint replacement, suggesting a potential therapeutic effect of metformin in patients with osteoarthritis,” writes Changhai Ding. Southern Medical University, Guangzhou, China.
Despite the low number of total knee replacements and a relatively short 4-year follow-up period, we found a statistically significant reduction in the TKR rate of 19% in the diabetic population who used regular metformin compared with nonusers. clear dose-response relationship.
The prevalence of total knee replacement suggests a potential slowing of the progression of osteoarthritis in patients with type 2 diabetes who regularly take metformin. With predicted biologic effects on meta-inflammation and weight loss, metformin may be used as a disease-modifying drug for people with knee osteoarthritis. Future research should include longer follow-up studies, more specific selection of individuals diagnosed with knee OA and its severity, and information on metformin dosing.
- The global, regional and national burden of osteoarthritis 1990-2017: a systematic review of the Global Burden of Disease Study 2017 – (https://pubmed.ncbi.nlm.nih.gov/32398285/)
- Metformin use and risk of total knee replacement among diabetic patients: a propensity-score-matched retrospective cohort study – (https://pubmed.ncbi.nlm.nih.gov/35798867/)