Metformin in patients with psoriasis
Authors:
Martin Jozef Péč 1; Jakub Jurica 1; Monika Péčová 2; Matej Samoš 1,3; Peter Galajda 1; Marián Mokáň 1
Authors‘ workplace:
I. interná klinika JLF UK a UNM, Martin
1; Onkologické centrum a Klinika hematológie a transfuziológie JLF UK a UNM, Martin
2; Oddelenie akútnej kardiológie SÚSCCH a. s., Banská Bystrica
3
Published in:
Forum Diab 2024; 13(1): 37-41
Overview
Metformin is the gold standard for the treatment of type 2 diabetes mellitus. However, it has been shown to have potential benefits for psoriasis patients as well. Metformin, in addition to its hypoglycemic effect, has demonstrated a direct anti-inflammatory effect through activation of adenosine monophosphate-activated protein kinase and inhibition of inflammatory cytokines. Studies suggest that metformin can improve symptoms of psoriasis and metabolic syndrome, showing even greater results when combined with other treatment modalities. Additional evidence suggests a possible prevention of the development of psoriasis in diabetic patients, and its combined use with other drugs may lead to improved quality of life and reduced cardiovascular risk factors. At the same time, studies have shown the safety of metformin in patients with psoriasis. However, further randomized clinical trials are needed to confirm its effectiveness and role in the treatment of psoriasis.
Keywords:
metformin – metabolic syndrome – Psoriasis – type 2 diabetes mellitus
Sources
Davies MJ, Aroda VR, Collins BS et al. Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2022; 45(11): 2753–2786. Dostupné z DOI: <http://dx.doi.org/10.2337/dci22–0034>.
Mallik R, Chowdhury TA. Metformin in cancer. Diabetes Res Clin Pract 2018; 143: 409–419. Dostupné z DOI: <http://dx.doi.org/10.1016/j.diabres.2018.05.023>.
Rawshani A, Rawshani A, Franzén S et al. Risk Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2018; 379(7): 633–644. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1800256>.
Mohammed I, Hollenberg MD, Ding H et al. A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan. Front Endocrinol (Lausanne) 2021; 12: 718942. Dostupné z DOI: <http://dx.doi.org/10.3389/fendo.2021.718942>.
Notaro ALG, Neto FTL. The use of metformin in women with polycystic ovary syndrome: an updated review. J Assist Reprod Genet 2022; 39(3): 573–579. Dostupné z DOI: <http://dx.doi.org/10.1007/s10815–022–02429–9>.
Nestle FO, Kaplan DH, Barker J. Psoriasis. N Engl J Med 2009; 361(5): 496–509. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMra0804595>.
Parisi R, Symmons DP, Griffiths CE et al. [Identification and Management of Psoriasis and Associated ComorbidiTy (IMPACT) project team]. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol 2013; 133(2): 377–385. Dostupné z DOI: <http://dx.doi.org/10.1038/jid.2012.339>.
Branisteanu DE, Cojocaru C, Diaconu R et al. Update on the etiopathogenesis of psoriasis (Review). Exp Ther Med 2022; 23(3): 201. Dostupné z DOI: <http://dx.doi.org/10.3892/etm.2022.11124>.
Yamazaki F. Psoriasis: Comorbidities. J Dermatol 2021; 48(6): 732–740. Dostupné z DOI: <http://dx.doi.org/10.1111/1346–8138.15840
Singh S, Bhansali A. Randomized Placebo Control Study of Metformin in Psoriasis Patients with Metabolic Syndrome (Systemic Treatment Cohort). Indian J Endocrinol Metab 2017; 21(4): 581–587. Dostupné z DOI: <http://dx.doi.org/10.4103/ijem.IJEM_46_17>.
Glossmann H, Reider N. A marriage of two “Methusalem” drugs for the treatment of psoriasis?: Arguments for a pilot trial with metformin as add-on for methotrexate. Dermatoendocrinol 2013; 5(2): 252–263. Dostupné z DOI: <http://dx.doi.org/10.4161/derm.23874>.
Li W, Ma W, Zhong H et al. Metformin inhibits proliferation of human keratinocytes through a mechanism associated with activation of the MAPK signaling pathway. Exp Ther Med 2014; 7(2): 389–392. Dostupné z DOI: <http://dx.doi.org/10.3892/etm.2013.1416>.
Huang Z, Li J, Chen H et al. The efficacy of metformin for the treatment of psoriasis: a meta-analysis study. Postepy Dermatol Alergol 2023; 40(5): 606–610. Dostupné z DOI: <http://dx.doi.org/10.5114/ada.2023.130524>.
Liu Y, Yang F, Ma W et al. Metformin inhibits proliferation and proinflammatory cytokines of human keratinocytes in vitro via mTOR-signaling pathway. Pharm Biol 2016; 54(7): 1173–1178. Dostupné z DOI: <http://dx.doi.org/10.3109/13880209.2015.1057652>.
Wang X, Li R, Zhao X et al. Metformin Promotes HaCaT Cell Apoptosis through Generation of Reactive Oxygen Species via Raf-1-ERK1/2-Nrf2 Inactivation. Inflammation 2018; 41(3): 948–958. Dostupné z DOI: <http://dx.doi.org/10.1007/s10753–018–0749-z>.
Ip W, Kirchhof MG. Glycemic Control in the Treatment of Psoriasis. Dermatology 2017; 233(1): 23–29. Dostupné z DOI: <http://dx.doi.org/10.1159/000472149>.
Tsuji G, Hashimoto-Hachiya A, Yen VH et al. Metformin inhibits IL-1β secretion via impairment of NLRP3 inflammasome in keratinocytes: implications for preventing the development of psoriasis. Cell Death Discov 2020; 6: 11. Dostupné z DOI: <http://dx.doi.org/10.1038/s41420–020–0245–8>.
Hadi NR, Al-Amran FG, Swadi A. Metformin ameliorates methotrexate-induced hepatotoxicity. J Pharmacol Pharmacother 2012; 3(3): 248–253. Dostupné z DOI: <http://dx.doi.org/10.4103/0976–500X.99426>.
Xuan THT, Thi VB, Ngoc AT et al. Quality of Life in Psoriasis Vietnamese Patients Treated with Metformin in Combination with Methotrexate. Open Access Maced J Med Sci 2019; 7(2): 302–303. Dostupné z DOI: <http://dx.doi.org/10.3889/oamjms.2019.066>.
Kim SC, Schneeweiss S, Glynn RJ et al. Dipeptidyl peptidase-4 inhibitors in type 2 diabetes may reduce the risk of autoimmune diseases: a population-based cohort study. Ann Rheum Dis 2015; 74(11): 1968–1975. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2014–205216>.
Wu CY, Shieh JJ, Shen JL et al. Association between antidiabetic drugs and psoriasis risk in diabetic patients: results from a nationwide nested case-control study in Taiwan. J Am Acad Dermatol 2015; 72(1): 123–130. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jaad.2014.08.042>.
Tseng CH. Differential Effects of Metformin on Immune-Mediated and Androgen-Mediated Non-Cancer Skin Diseases in Diabetes Patients: A Retrospective Cohort Study. Dermatology 2023; 239(4): 542–552. Dostupné z DOI: <http://dx.doi.org/10.1159/000530077>.
Singh S, Bhansali A. Randomized placebo control study of insulin sensitizers (Metformin and Pioglitazone) in psoriasis patients with metabolic syndrome (Topical Treatment Cohort). BMC Dermatol 2016; 16(1): 12. Dostupné z DOI: <http://dx.doi.org/10.1186/s12895–016–0049-y>.
Singh S, Bhansali A. Randomized Placebo Control Study of Metformin in Psoriasis Patients with Metabolic Syndrome (Systemic Treatment Cohort). Indian J Endocrinol Metab 2017; 21(4): 581–587. Dostupné z DOI: <http://dx.doi.org/10.4103/ijem.IJEM_46_17>.
Łebkowska A, Krentowska A, Adamska A et al. Type B insulin resistance syndrome associated with connective tissue disease and psoriasis. Endocrinol Diabetes Metab Case Rep 2020; 2020:20–0027. Dostupné z DOI: <http://dx.doi.org/10.1530/EDM-20–0027>.
Moore AF, Soper T, Jones N et al. Psoriatic exacerbation associated with insulin therapy. Diabetes Care 2008; 31(5): e31. Dostupné z DOI: <http://dx.doi.org/10.2337/dc08–0230>.
El-Gharabawy RM, Ahmed AS, Al-Najjar AH. Mechanism of action and effect of immune-modulating agents in the treatment of psoriasis. Biomed Pharmacother 2017; 85: 141–147. Dostupné z DOI: <http://dx.doi.org/10.1016/j.biopha.2016.11.105>.
Tam HTX, Thuy LND, Vinh NM et al. The Combined Use of Metformin and Methotrexate in Psoriasis Patients with Metabolic Syndrome. Dermatol Res Pract 2022; 2022: 9838867. Dostupné z DOI: <http://dx.doi.org/10.1155/2022/9838867>.
Brauchli YB, Jick SS, Curtin F et al. Association between use of thiazolidinediones or other oral antidiabetics and psoriasis: A population based case-control study. J Am Acad Dermatol 2008; 58(3): 421–429. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jaad.2007.11.023>.
Su YJ, Chen TH, Hsu CY et al. Safety of Metformin in Psoriasis Patients With Diabetes Mellitus: A 17-Year Population-Based Real-World Cohort Study. J Clin Endocrinol Metab 2019; 104(8): 3279–3286. Dostupné z DOI: <http://dx.doi.org/10.1210/jc.2018–02526>.
Matsuda-Taniguchi T, Takemura M, Nakahara T et al. The Antidiabetic Agent Metformin Inhibits IL-23 Production in Murine Bone-Marrow-Derived Dendritic Cells. J Clin Med 2021; 10(23): 5610. Dostupné z DOI: <http://dx.doi.org/10.3390/jcm10235610>.
Xiao Y, Jing D, Zhou G et al. Adenosine 5’monophosphate-activated protein kinase activation reduces the risks of psoriasis and its comorbidities: a mendelian randomisation study in the UK Biobank. Rheumatology (Oxford) 2023; kead462. Dostupné z DOI: <http://dx.doi.org/10.1093/rheumatology/kead462>.
Stanescu AM, Simionescu AA, Florea M et al. Is Metformin a Possible Beneficial Treatment for Psoriasis? A Scoping Review. J Pers Med 2021; 11(4): 251. Dostupné z DOI: <http://dx.doi.org/10.3390/jpm11040251>.
Galajda P, Mokáň Mi, Mokáň Ma. Metabolický syndróm a prediabetické stavy [Metabolic syndrome and prediabetic states]. Vnitř Lék 2013; 59(6): 453–458.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Forum Diabetologicum
![Issue 1](https://www.forumdiabetologicum.sk/media/cache/resolve/journal_issue/media/image/8a0ee84768d1aa2a2c49b5d7a56b74c9.jpg)
2024 Issue 1
Most read in this issue
- Folistatin and type 2 diabetes mellitus
- Long term protective effects of empagliflozine in whole spectrum of patients with type 2 diabetes mellitus from early stages of disease
- Telemedicine in outpatient diabetes practice
- New recommendations for arterial hypertension management and blood pressure targets for type 2 diabetes mellitus