Metformin can be safely prescribed to patients with diabetes and psoriasis, according to study findings published in The Journal of Clinical Endocrinology & Metabolism.

Some research has reported that metformin can worsen psoriasis, but randomized placebo controlled clinical trials have shown beneficial effects of metformin in patients with psoriasis. However, these studies had a limited number of cases and were conducted in a controlled situation. In the current study, researchers evaluated the safety of metformin in patients with type 2 diabetes and psoriasis in a nationwide retrospective cohort study to observe what effect long-term treatment with metformin had in this population in a real-world setting.

The National Health Insurance Research Database in Taiwan was used to identify all patients with type 2 diabetes and psoriasis from 1997 to 2013 who were then stratified by whether or not they were using metformin for diabetes control. Study end points included all-cause mortality, severe psoriasis, hospitalization because of psoriasis, and any cause for readmission.

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In the final analysis, the metformin group included 5520 patients and the nonmetformin group included 3062 patients. There were no significant differences observed in the risks for all-cause mortality (hazard ratio [HR], 1.08; 95% CI, 0.90-1.30), severe psoriasis (HR, 0.95; 95% CI, 0.80-1.09), psoriasis-related admission (HR, 1.32; 95% CI, 0.90-1.93), and any-cause hospital readmission (HR, 0.99; 95% CI, 0.90-1.11) between the 2 cohorts. There was also no significant increase in the risk for severe psoriasis and psoriasis-related admission in a dose-dependent analysis, even among patients treated with >80 defined daily doses or a prescribed daily dose >1000 mg (P for linear trend >.05).

“This study can serve as a reference for physicians treating [patients with diabetes and psoriasis] to prescribe metformin without safety concerns,” wrote the researchers.

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Reference

Su YJ, Chen TH, Hsu CY, Chiu WT, Lin YS, Chi CC. Safety of metformin in psoriasis patients with diabetes mellitus: a 17-year population-based real-world cohort study [published online February 19, 2019]. J Clin Endocrinol Metab. doi:10.1210/jc.2018-02526