Diabetes drug metformin may improve asthma exacerbations, finds study

USA: The diabetes drug metformin may improve asthma exacerbations, a recent study in the Annals of the American Thoracic Society has found. Exacerbation is defined as an asthma-related hospitalization, emergency department visit, or filling of a systemic corticosteroid within 14 days of an asthma-related ambulatory visit.

According to the study, metformin initiation in patients with diabetes and asthma lowered for asthma-related emergency department visits and hospitalizations.

Metabolic syndrome and diabetes are associated with worsened asthma control. Metformin, the first-line medication for the treatment of type 2 diabetes, improves metabolic function and insulin resistance. Experimental studies have demonstrated the role of metformin in improving pathologic features of asthma, but evidence of clinical benefit is limited.

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Tianshi David Wu, Johns Hopkins School of Medicine, Department of Medicine, Baltimore, Maryland, USA, and colleagues determined metformin treatment in a cohort of individuals with asthma and diabetes is associated with a lower risk of asthma exacerbation.

This retrospective cohort study spanning 6 years involved 23,920 adults (aged over 18) with asthma and diabetes, assembled from a national administrative claims database. New metformin users were matched to non-users by propensity score based on demographics, comorbidity, and medication-use characteristics. Cox proportional hazards estimated the change in hazard of asthma exacerbation associated with metformin initiation.

In a cohort of 23,920 individuals with asthma and diabetes, metformin initiation was associated with a lower hazard of asthma exacerbation, driven by lower hazards of asthma-related emergency department visits and hospitalization, without differences in corticosteroid use.

"Our findings suggest a possible benefit of metformin in more severe asthma exacerbations. More detailed participant characterization with investigation within cohorts is necessary," concluded the authors.

To read the complete study log on to https://doi.org/10.1513/AnnalsATS.201812-897OC