Effect of Metformin on Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive illness characterized by considerable mortality and morbidity. Metformin may help with COPD in more ways than just lowering blood sugar levels. It might additionally possess anti-inflammatory properties.
Objective: To evaluate the effect of metformin on acute exacerbations, pulmonary function, and quality of life in non-diabetic COPD patients.

Methodology: In this single-center, pragmatic randomized controlled trial, 152 non-diabetic COPD patients were randomly assigned either metformin (500 mg twice daily) or conventional treatment for a duration of 6 months. The primary outcome was how often acute exacerbations were experienced. Secondary outcomes encompassed change in pulmonary function tests, functional status through COPD Assessment Test (CAT), the BODE Index, and HbA1c levels.
Results: Total 144 patients completed randomization process among both groups. After 6 months, pulmonary functions, FEV1(52.6±10.2 Vs. 46.4±11.8, p<.001), FVC (72.1±8.1 Vs. 66.6±11.6, P<.001), and FEV1/FVC (72.6 ± 8.3 Vs. 69.1±9.1, p=.01) were significantly improved in the metformin group compared with the control group. There was no statistically significant difference in the frequency of acute exacerbations (3.19±2.7 Vs. 3.5±3.1, p=0.55), CAT score (15.8 ±10.6 Vs. 15.5±9.2, p=.86), mMRC (1.46±1.2 Vs. 1.4±1.1, p=.94) or BODE Index (3.1±2.5 Vs. 3.06±2.5, p=.47) across the groups. The metformin group had a more significant decrease in HbA1c (5.38 ± 0.27% vs 5.83 ± 0.58%; p<0.001).

Conclusion: Metformin significantly improved pulmonary function but failed to decrease exacerbation frequency or improving quality of life in non-diabetic COPD patients. Its key advantage is still controlling blood sugar levels.