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J Thorac Dis. 2019 Oct;11(10):4371-4378. doi: 10.21037/jtd.2019.09.84.

Role of metformin in treatment of patients with chronic obstructive pulmonary disease: a systematic review.

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Department of Respiratory Medicine, Nanjing Meishan Hospital, Nanjing 210039, China.
Department of Respiratory Medicine, Jiangsu Province Cancer Hospital, Nanjing 210009, China.
Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.


Chronic obstructive pulmonary disease (COPD) is commonly associated with type 2 diabetes mellitus (T2DM). Metformin is a first-line treatment for most patients with T2DM, and may have antiaging, antioxidant, and anti-tumour effects. A few published studies report the use of metformin for the treatment of COPD in patients with or without T2DM, but the results are inconsistent. This study aimed to confirm the effectiveness and safety of metformin as a treatment option in patients with COPD. We performed a systematic search of PubMed, EMBASE, and the Cochrane database from their starting date to December 2017. Randomised controlled trials (RCTs), controlled clinical trials, and retrospective researches reporting the use of metformin for treating patients with COPD were identified. We included a total of six articles (involving 3,467 participants) and found that metformin may benefit patients with COPD and T2DM by improving health status and symptoms, hospitalisations, and mortality. There was no effect on patients with COPD without T2DM. Metformin causes minimal increases in plasma lactate concentrations without lactic acidosis and has little impact on blood glucose and minor adverse events. Metformin is safe and effective for treating COPD in patients with concomitant T2DM.


Chronic obstructive pulmonary disease (COPD); antiaging; effectiveness; metformin; safety; type 2 diabetes mellitus (T2DM)

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Conflicts of Interest: The authors have no conflicts of interest to declare.

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