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.
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.
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