Impact of metformin on the risk and treatment outcomes of tuberculosis in diabetics: a systematic review

Abstract Background Tuberculosis (TB) remains one of the infectious diseases with a leading cause of death among adults worldwide. Metformin, a first-line medication for the treatment of type 2 diabetes, may have potential for treating TB. The aims of the present systematic review were to evaluate t...

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Main Authors: Xinyu Yu, Ling Li, Liangtao Xia, Xin Feng, Fan Chen, Shiyi Cao, Xiang Wei
Format: Article
Language:English
Published: BMC 2019-10-01
Series:BMC Infectious Diseases
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12879-019-4548-4
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author Xinyu Yu
Ling Li
Liangtao Xia
Xin Feng
Fan Chen
Shiyi Cao
Xiang Wei
author_facet Xinyu Yu
Ling Li
Liangtao Xia
Xin Feng
Fan Chen
Shiyi Cao
Xiang Wei
author_sort Xinyu Yu
collection DOAJ
description Abstract Background Tuberculosis (TB) remains one of the infectious diseases with a leading cause of death among adults worldwide. Metformin, a first-line medication for the treatment of type 2 diabetes, may have potential for treating TB. The aims of the present systematic review were to evaluate the impact of metformin prescription on the risk of tuberculosis diseases, the risk of latent TB infection (LTBI) and treatment outcomes of tuberculosis among patients with diabetic mellitus. Methods Databases were searched through March 2019. Observational studies reporting the effect of metformin prescription on the risk and treatment outcomes of TB were included in the systematic review. We qualitatively analyzed results of included studies, and then pooled estimate effects with 95% confidence intervals (CIs) of different outcome using random-effect meta-analyses. Results This systematic review included 6980 cases from 12 observational studies. The meta-analysis suggested that metformin prescription could decrease the risk of TB among diabetics (pooled odds ratio [OR], 0.38; 95%CI, 0.21 to 0.66). Metformin prescription was not related to a lower risk of LTBI (OR, 0.73; 95%CI, 0.30 to 1.79) in patients with diabetes. Metformin medication during the anti-tuberculosis treatment is significantly associated with a smaller TB mortality (OR, 0.47; 95%CI, 0.27 to 0.83), and a higher probability of sputum culture conversion at 2 months of TB disease (OR, 2.72; 95%CI, 1.11 to 6.69) among patients with diabetes. The relapse of TB was not statistically reduced by metformin prescription (OR, 0.55; 95%CI, 0.04 to 8.25) in diabetics. Conclusions According to current observational evidence, metformin prescription significantly reduced the risk of TB in patients with diabetes mellitus. Treatment outcomes of TB disease could also be improved by the metformin medication among diabetics.
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spelling doaj.art-5838931892874ee3b582410ebcd40c532022-12-21T22:51:34ZengBMCBMC Infectious Diseases1471-23342019-10-0119111110.1186/s12879-019-4548-4Impact of metformin on the risk and treatment outcomes of tuberculosis in diabetics: a systematic reviewXinyu Yu0Ling Li1Liangtao Xia2Xin Feng3Fan Chen4Shiyi Cao5Xiang Wei6Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDivision of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDivision of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologySchool of Public Health, Tongji Medical College, Huazhong University of Science and TechnologySchool of Public Health, Tongji Medical College, Huazhong University of Science and TechnologyDivision of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background Tuberculosis (TB) remains one of the infectious diseases with a leading cause of death among adults worldwide. Metformin, a first-line medication for the treatment of type 2 diabetes, may have potential for treating TB. The aims of the present systematic review were to evaluate the impact of metformin prescription on the risk of tuberculosis diseases, the risk of latent TB infection (LTBI) and treatment outcomes of tuberculosis among patients with diabetic mellitus. Methods Databases were searched through March 2019. Observational studies reporting the effect of metformin prescription on the risk and treatment outcomes of TB were included in the systematic review. We qualitatively analyzed results of included studies, and then pooled estimate effects with 95% confidence intervals (CIs) of different outcome using random-effect meta-analyses. Results This systematic review included 6980 cases from 12 observational studies. The meta-analysis suggested that metformin prescription could decrease the risk of TB among diabetics (pooled odds ratio [OR], 0.38; 95%CI, 0.21 to 0.66). Metformin prescription was not related to a lower risk of LTBI (OR, 0.73; 95%CI, 0.30 to 1.79) in patients with diabetes. Metformin medication during the anti-tuberculosis treatment is significantly associated with a smaller TB mortality (OR, 0.47; 95%CI, 0.27 to 0.83), and a higher probability of sputum culture conversion at 2 months of TB disease (OR, 2.72; 95%CI, 1.11 to 6.69) among patients with diabetes. The relapse of TB was not statistically reduced by metformin prescription (OR, 0.55; 95%CI, 0.04 to 8.25) in diabetics. Conclusions According to current observational evidence, metformin prescription significantly reduced the risk of TB in patients with diabetes mellitus. Treatment outcomes of TB disease could also be improved by the metformin medication among diabetics.http://link.springer.com/article/10.1186/s12879-019-4548-4MetforminTuberculosisMeta-analysis
spellingShingle Xinyu Yu
Ling Li
Liangtao Xia
Xin Feng
Fan Chen
Shiyi Cao
Xiang Wei
Impact of metformin on the risk and treatment outcomes of tuberculosis in diabetics: a systematic review
BMC Infectious Diseases
Metformin
Tuberculosis
Meta-analysis
title Impact of metformin on the risk and treatment outcomes of tuberculosis in diabetics: a systematic review
title_full Impact of metformin on the risk and treatment outcomes of tuberculosis in diabetics: a systematic review
title_fullStr Impact of metformin on the risk and treatment outcomes of tuberculosis in diabetics: a systematic review
title_full_unstemmed Impact of metformin on the risk and treatment outcomes of tuberculosis in diabetics: a systematic review
title_short Impact of metformin on the risk and treatment outcomes of tuberculosis in diabetics: a systematic review
title_sort impact of metformin on the risk and treatment outcomes of tuberculosis in diabetics a systematic review
topic Metformin
Tuberculosis
Meta-analysis
url http://link.springer.com/article/10.1186/s12879-019-4548-4
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