(C-250) Does exposure to metformin impact asthma-related outcomes and the risk of asthma-onset?

Tuesday, August 26, 2025

12:00 PM - 1:30 PM ET

Presenting Author(s)

LR

L. Yesenia Rodríguez-Tanta, PharmD

Grupo Peruano de Investigación en Medicamentos, Políticas y Servicios Farmacéuticos (GPIMPSF), Carrera de Farmacia y Bioquímica, Universidad Científica del Sur, Lima, Peru, Peru

Co-Author(s)

VL

Victor Lechuga Noa, PharmD

Grupo Peruano de Investigación en Medicamentos, Políticas y Servicios Farmacéuticos (GPIMPSF), Carrera de Farmacia y Bioquímica, Universidad Científica del Sur, Lima, Peru, Lima, Peru
GB

Graciela Balbin- Ramon, MD

Hospital de Emergencias José Casimiro Ulloa, Peru

Background: Metformin is one of the most widely used antidiabetic medications globally and its impact on asthma remains controversial.

Objectives: To evaluate and analyze the existing scientific evidence on the impact of metformin on asthma-related outcomes and its potential role in the onset of asthma

Methods: We conducted a systematic review (SR) to synthesize and evaluate its impact on asthma-related outcomes and the risk of asthma onset. This SR adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The risk of bias was assessed using the ROBINS-E tool, and the certainty of evidence was evaluated using the GRADE approach. Only pharmacoepidemiologic studies were included.

Results: We included in a total of eight studies (five on asthma-related outcomes and three on the risk of asthma onset). The association between metformin and the risk of asthma exacerbation, when compared to non-metformin users, remained uncertain (4 studies; HR = 0.89; 95% CI 0.56–1.43; I² = 94.2%; Cochran’s Q test p-value < 0.001). We found low certainty that metformin may reduce the risk of asthma-related hospitalizations (5 studies, 7 cohorts; HR = 0.73; 95% CI 0.47–1.12; I² = 83.7%; Cochran’s Q test p-value < 0.002), asthma-related emergency room visits (4 studies; HR = 0.45; 95% CI 0.22–0.93; I² = 83.7%; Cochran’s Q test p-value < 0.002), or the need for systemic corticosteroids (3 studies, 5 cohorts; HR = 0.45; 95% CI 0.22–0.93; I² = 72.3%; Cochran’s Q test p-value < 0.006), compared to non-metformin users or other antidiabetics users. Finally, there was low certainty regarding the potential reduction in the risk of asthma onset with metformin compared to non-metformin users (3 studies, 5 cohorts; HR = 0.91; 95% CI 0.72–1.15; I² = 90.5%; Cochran’s Q test p-value < 0.001).

Conclusions: Our findings suggest that metformin might differentially impact asthma-related outcomes, with the most pronounced effect observed in reducing the need for systemic corticosteroids.