Canada: Diabetes drug metformin yielded modest but favorable effects on insulin resistance and weight in obese children and adolescents, according to a systematic review in the journal Pediatrics. Also, the drug showed tolerable safety profile in the pediatric population.
According to the authors, the evidence driving that conclusion was of "varying quality."
"The available evidence is of varying quality, with high heterogeneity between trials, suggesting some uncertainty in the benefits of metformin in this population," they wrote.
Reem Masarwa, Jewish General Hospital, Montreal, Quebec, Canada, and colleagues aimed to assess the efficacy and safety of metformin via systematic review.
For the purpose, the researchers searched online databases from inception to November 2019. They included randomized controlled trials (RCTs) in which researchers assessed the efficacy and safety of metformin with lifestyle interventions, compared with a placebo with lifestyle interventions, in children and adolescents with obesity.
The primary outcomes were mean changes from baseline in BMI, BMI z score, homeostatic model assessment of insulin resistance, and gastrointestinal adverse effects.
The review included 24 RCTs consisting of 1623 patients (aged 4 to 19 years). Follow-up ranged from 2 months to 2 years.
Key findings of the study include:
Metformin resulted in a modest decrease in BMI (range of mean values: −2.70 to 1.30 vs −1.12 to 1.90), BMI z score (range of mean values: −0.37 to −0.03 vs −0.22 to 0.15), and homeostatic model assessment of insulin resistance (range of mean values: −3.74 to 1.00 vs −1.40 to 2.66).
Metformin resulted in a higher frequency of gastrointestinal adverse effects (range: 2% to 74% vs 0% to 42%).
"With this systematic review of RCTs, we suggest that metformin has modest but favorable effects on weight and insulin resistance and a tolerable safety profile among children and adolescents with obesity," concluded the authors.
The study titled, "Efficacy and Safety of Metformin for Obesity: A Systematic Review," is published in the journal Pediatrics.
DOI: https://pediatrics.aappublications.org/content/early/2021/02/17/peds.2020-1610