Diabetes drug ‘could reduce harmful steroid side effects’

A drug used to treat type 2 diabetes could help reduce harmful side effects of steroids, according to research.

Scientists from Queen Mary University of London looked at the effects of metformin on patients who were prescribed high doses of glucocorticoids, a type of steroids used to treat chronic inflammatory diseases (CID).

They believe the diabetes drug could be “simple and cheap solution” to reduce unwanted glucocorticoids side effects, which include loss of bone and muscle mass, high sugar levels, and increased risk of infection.

Marta Korbonits, professor of endocrinology at Barts and the London School of Medicine and Dentistry at Queen Mary, said: “Our findings are strikingly positive and suggest that a simple and immediately available intervention, treatment with the diabetes drug metformin, can improve the clinical status of patients on glucocorticoid treatment, even if they do not have diabetes.”

She added: “Whilst developed countries may be increasing the use of biologics or other steroid-sparing agents, in many other parts of the world, there’s still a heavy reliance on glucocorticoids.

“Therefore, doctors and patients have been waiting for a safe, cheap and effective treatment that can prevent the major metabolic complications of these medicines, but does not affect, or could even improve, their anti-inflammatory properties.

“Our results suggest metformin has the potential to help these patients.”

Glucocorticoids are used to treat CID where the immune system is overactive, including rheumatoid arthritis and asthma.

Long-term steroid use can lead to a potentially fatal disorder known as Cushing’s syndrome.

The researchers looked at 53 non-diabetic patients with CID from Barts Health NHS Trust as part of the phase 2 clinical trial.

Metformin and placebo were administered orally to each patient for 12 weeks.

The participants were offered escalating doses of metformin and placebo, which included 850 mg a day for the first five days, 850 mg twice a day for the next five days, and 850 mg three times a day for the rest of the study duration.

As it was a double-blind randomised trial, neither the researchers nor the volunteers knew who was taking metformin and who was receiving the placebo.

They found patients treated with metformin showed improved outcomes, which included a 30% reduction in the rate of infections and lower hospital admissions, compared to the placebo group.

They also observed that the diabetes drug “strengthened the intended anti-inflammatory effects of glucocorticoids” and had “beneficial results” on markers related to cardiovascular, metabolic and bone health.

The study, published in the journal The Lancet Diabetes & Endocrinology, is funded by Barts Charity.