Investigating the effect of metformin on disease activity in systemic lupus erythematosus
DOI:
https://doi.org/10.64149/J.Carcinog.24.10s.122-128Keywords:
Systemic lupus erythematosus, metformin, disease activity, inflammatory markers, insulin sensitivity, HOMA-IR, lipid profilesAbstract
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multi-organ inflammation and immune system dysregulation.
Objective: To evaluate the effects of metformin on disease activity, inflammatory markers, insulin sensitivity, and lipid profiles in patients with systemic lupus erythematosus.
Methods: A total of 155 patients with SLE were enrolled in this prospective, open-label study. Patients were randomized into two groups: 78 patients in the metformin group received metformin (500 mg twice daily, titrated to 2000 mg/day) alongside standard SLE management, and 77 patients in the control group received standard treatment alone. Disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and inflammatory cytokines (IL-6 and TNF-α), insulin sensitivity (HOMA-IR), and lipid profiles were measured at baseline and after 12 months.
Results: The metformin group showed a significant reduction in SLEDAI score from 10.2 ± 4.1 to 6.4 ± 3.2 (p < 0.001), compared to the control group, which exhibited a minimal decrease from 9.8 ± 3.9 to 9.2 ± 3.6 (p = 0.09). Inflammatory markers, including IL-6 and TNF-α, decreased significantly in the metformin group (p < 0.001). Metabolic parameters also improved, with a significant reduction in HOMA-IR (2.3 ± 1.4 to 1.5 ± 0.9, p < 0.001) and fasting blood glucose (121.4 ± 23.2 mg/dL to 98.7 ± 18.4 mg/dL, p < 0.001). Lipid profiles improved in the metformin group, with significant reductions in total cholesterol (211.6 ± 32.5 mg/dL to 194.3 ± 27.6 mg/dL, p = 0.02) and LDL cholesterol (129.4 ± 28.6 mg/dL to 118.2 ± 24.7 mg/dL, p = 0.03).
Conclusion: Metformin significantly reduced disease activity and improved both inflammatory markers and metabolic parameters in patients with SLE. These findings suggest that metformin may serve as a beneficial adjunctive therapy for SLE, particularly in patients with metabolic comorbidities.
