Time course and dose effect of metformin on weight in patients with different disease states

ABSTRACT

Objectives

The present study was to quantitate and compare the efficacy of metformin on weight in different disease states using model-based meta-analysis (MBMA).

Methods

Randomized controlled trials (RCT) of metformin effects on weight in different disease states were collected by searching the public databases. The change rate of weight from baseline was selected as the efficacy indicator.

Results

A total 21 RCTs containing 1885 patients including patients with type 2 diabetes mellitus, patients with antipsychotic induced weight gain, patients with obesity, were included into the present study. After deducting placebo effect, the maximal effect (E_max) of metformin on weight in patients with type 2 diabetes mellitus, patients with antipsychotic induced weight gain, patients with obesity were −6.86%, −8.82%, and −4.14%, respectively. The treatment duration to reach half of the maximal effect (ET₅₀) were 107, 45.5, and 15.1 weeks, respectively. Within the metformin dose range from 21 RCTs, no significant dose–response relationship was observed. However, the time–course relationship is obvious for efficacy of metformin on weight.

Conclusions

The present study firstly provided quantitative information for metformin effects on weight in different disease states, including patients with type 2 diabetes mellitus, patients with antipsychotic induced weight gain, patients with obesity.

KEYWORDS:

• Metformin
• weight
• type 2 diabetes mellitus
• antipsychotic induced weight gain
• obesity

Article highlights

• The present study firstly provided quantitative information for metformin effect on weight in different disease states, including patients with type 2 diabetes mellitus, patients with antipsychotic induced weight gain, patients with obesity.

• For patients with type 2 diabetes mellitus, a dose of 1000 mg/day metformin is required for at least 107 weeks to play a better effect, 428 weeks to achieve maximum efficacy.

• For patients with antipsychotic induced weight gain, a dose of 500 mg/day metformin is required for 45.5 weeks to play a better effect, 182 weeks to achieve maximum efficacy.

• For patients with obesity, a dose of 1000 mg/day metformin is required for 15.1 weeks to play a better effect, 61 weeks to achieve maximum efficacy.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosure

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Authors contributions

X. Chen, D. Wang and Z. Li conceived and designed the study. X. Chen and D. Wang collected and analyzed data. X. Chen and D. Wang wrote, reviewed and edited the manuscript. All authors read and approved the final manuscript.

Additional information

Funding

This work was supported by Scientific Research Project of Science and Technology Commission of Shanghai Municipality [grant no. 18DZ1910604/19DZ1910703]; Shanghai Science and Techonology Commission [grant no. 19XD1400900]; and The China Scholarship Council [grant no. 201906100164].