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Medicine Dec 2023Metformin is an old drug used for the treatment of type 2 diabetes mellitus and can play a variety of roles by regulating the gut microbiota. The number of research...
BACKGROUND
Metformin is an old drug used for the treatment of type 2 diabetes mellitus and can play a variety of roles by regulating the gut microbiota. The number of research articles on metformin in the gut microbiota has increased annually; however, no bibliometric tools have been used to analyze the research status and hot trends in this field. This study presents a bibliometric analysis of publications on metformin and gut microbiota.
METHODS
We searched the Web of Science core collection database on June 8, 2023, for papers related to metformin and gut microbiota from 2012 to 2022. We used Microsoft Excel 2021, VOSviewer1.6.19, CiteSpace 6.2.4, and R software package "bibliometrix" 4.0.0 to analyze the countries, institutions, authors, journals, citations, and keywords of the included publications.
RESULTS
We included 517 papers, and the trend in publications increased over the last 11 years. The 517 articles were from 57 countries, including 991 institutions and 3316 authors, and were published in 259 journals. China led all countries (233 papers) and the most influential institution was the Chinese Academy of Sciences (16 papers). PLOS ONE (19 papers) was the most popular journal, and Nature (1598 citations) was the most cited journal. Li and Kim were the 2 most published authors (six papers each), and Cani (272 co-citations) was the most co-cited author. "Metabolites," "aging," and "intestinal barrier" were emerging topics in this field.
CONCLUSIONS
This bibliometric study comprehensively summarizes the research trends and progress of metformin and gut microbiota, and provides new research topics and trends for studying the effects of metformin on gut microbiota in different diseases.
Topics: Humans; Metformin; Gastrointestinal Microbiome; Diabetes Mellitus, Type 2; Academies and Institutes; Bibliometrics
PubMed: 38115325
DOI: 10.1097/MD.0000000000036478 -
Diabetes Care Jul 2023Observational and preclinical data suggest metformin may prevent severe coronavirus disease 2019 (COVID-19) outcomes. (Review)
Review
BACKGROUND
Observational and preclinical data suggest metformin may prevent severe coronavirus disease 2019 (COVID-19) outcomes.
PURPOSE
We conducted a systematic review of randomized, placebo-controlled clinical trials of metformin treatment for COVID-19 to determine whether metformin affects clinical or laboratory outcomes in individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and present a structured summary of preclinical data.
STUDY SELECTION
Two independent reviewers searched PubMed, Scopus, Cochrane COVID-19 Study Register, and ClinicalTrials.gov on 1 February 2023 with no date restrictions for trials where investigators randomized adults with COVID-19 to metformin versus control and assessed clinical and/or laboratory outcomes of interest. The Cochrane Risk of Bias 2 tool was used to assess bias.
DATA EXTRACTION
Two reviewers extracted data pertaining to prespecified outcomes of each interest from each included trial.
DATA SYNTHESIS
The synthesis plan was developed a priori and was guided by Synthesis Without Meta-analysis (SWiM) guidelines. Summary tables and narrative synthesis were used (PROSPERO, 2022, CRD42022349896). Three randomized trials met inclusion criteria. In two of the trials investigators found that metformin improved clinical outcomes (prevented need for oxygen and prevented need for acute health care use), and in the third trial a larger portion of adults with diabetes were enrolled but results did show a direction of benefit similar to that of the other trials in the per-protocol group. In the largest trial, subjects were enrolled during the delta and omicron waves and vaccinated individuals were included. The certainty of evidence that metformin prevents health care use due to COVID-19 was moderate per Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Many preclinical studies have shown metformin to be effective against SARS-CoV-2.
LIMITATIONS
Limitations include inclusion of only three trials and heterogeneity between trials.
CONCLUSIONS
Future trials will help define the role of metformin in COVID-19 treatment guidelines.
Topics: Adult; Humans; COVID-19; SARS-CoV-2; Metformin; COVID-19 Drug Treatment; Bias
PubMed: 37339345
DOI: 10.2337/dc22-2539 -
The Pan African Medical Journal 2023Polycystic ovarian syndrome (PCOS) is a metabolic and hormonal condition affecting women of a reproductive age. It causes an abnormal menstrual cycle, anovulation,... (Meta-Analysis)
Meta-Analysis Review
Polycystic ovarian syndrome (PCOS) is a metabolic and hormonal condition affecting women of a reproductive age. It causes an abnormal menstrual cycle, anovulation, infertility, acne, hirsutism, obesity, hyperlipidemia, and cardiovascular disorders. Because resveratrol decreases testosterone levels, it may be of value in treating PCOS. We aimed to evaluate the efficacy of resveratrol in treating women with PCOS. We searched for randomized clinical trials (RCTs) in PubMed, Cochrane CENTRAL, Scopus and Web of Science. With 95% confidence intervals, the data was retrieved and analyzed as a mean difference (MD) or a standardized mean difference (SMD). Four RCTs with 218 women were included in the analysis. Resveratrol significantly reduced testosterone (SMD = -0.40; 95% CI [-0.71, -0.10], P = 0.009), luteinizing hormone (LH) (SMD = -0.32; 95% CI [-0.62, 0.01], P = 0.04), and dehydroepiandrosterone sulfate (DHEAS) (MD = -0.85; 95% CI [-1.25, -0.45], P < 0.0001) compared with the placebo. Resveratrol is effective in treating women with PCOS due to reducing the levels of testosterone, LH, and DHEAS. In combination with other treatments, especially for hyperlipidemia, resveratrol is beneficial for women diagnosed with PCOS.
Topics: Female; Humans; Polycystic Ovary Syndrome; Resveratrol; Metformin; Randomized Controlled Trials as Topic; Testosterone
PubMed: 37333786
DOI: 10.11604/pamj.2023.44.134.32404 -
Frontiers in Endocrinology 2022Type 2 diabetes is more common in adults, but is becoming the major concern in children and adolescent recently. This study aimed to provide additional pharmaceutical... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Type 2 diabetes is more common in adults, but is becoming the major concern in children and adolescent recently. This study aimed to provide additional pharmaceutical management for children and adolescents with type 2 diabetes by assessing the efficacy and safety of several glucose-lowering drugs.
METHODS
Searches were performed in PubMed, Medline, Ovid, Cochrane Controlled Register of Trials (CENTRAL), and ClinicalTrials.gov that reported the efficacy and safety of drugs for children and adolescents with type 2 diabetes. Pooled effects were calculated by frequentist fixed effects network meta-analyses and additive network meta-analyses.
RESULTS
A total of 12 trials assessing eight glucose-lowering drugs were included, which compose of seven trials with monotherapy and five trials with combination therapies. Network meta-analysis results showed compared to placebo, saxagliptin+metformin (mean difference (MD) -1.91% [-2.85%, -0.97%]), liraglutide+metformin (MD -1.45% [-1.65%, -1.26%]), and liraglutide (MD -0.90% [-1.35%, -0.45%]) were the top 3 drugs that significantly reduced hemoglobin A1c (HbA1c). Sitagliptin+metformin, dapagliflozin, exenatide-2mcg, linagliptin-5mg, metformin, exenatide-5/10mcg, glimepiride, and sitagliptin also showed significant reduction in HbA1c. There were no significant differences between treatments in the incidence of adverse events, except that liraglutide+metformin had significant adverse effect such as abdominal pain. In addition, dapagliflozin, sitagliptin+metformin, and saxagliptin+metformin showed better efficacy compared with FDA-approved drugs.
CONCLUSIONS
The top 10 treatments of type 2 diabetes in children and adolescents aged 10-17 years were saxagliptin+metformin, liraglutide+metformin, liraglutide, dapagliflozin, exenatide-2 mcg, sitagliptin+metformin, linagliptin-5 mg, linagliptin-1 mg, metformin, and exenatide-5/10 mcg.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=284897, identifier CRD42021284897.
Topics: Adolescent; Adult; Child; Diabetes Mellitus, Type 2; Exenatide; Glucose; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Linagliptin; Liraglutide; Metformin; Network Meta-Analysis; Sitagliptin Phosphate
PubMed: 36034458
DOI: 10.3389/fendo.2022.897776 -
The Cochrane Database of Systematic... Jun 2014Parkinson's disease is one of the most common neurodegenerative disorders and mitochondrial dysfunction plays an important role in its pathogenesis. Creatine is... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Parkinson's disease is one of the most common neurodegenerative disorders and mitochondrial dysfunction plays an important role in its pathogenesis. Creatine is effective in improving mitochondrial function. It may therefore be useful for slowing the progression of Parkinson's disease.
OBJECTIVES
To assess the efficacy and safety of creatine used alone or as an adjuvant treatment for Parkinson's disease.
SEARCH METHODS
We searched the Cochrane Movement Disorders Group Trials Register, CENTRAL (The Cochrane Library 2013, November Issue 4), MEDLINE (January 1966 to 10 November 2013), EMBASE (1974 to 10 November 2013) and two Chinese databases. We searched ongoing trials registers and conference proceedings, checked reference lists and contacted authors of included trials.
SELECTION CRITERIA
Randomized controlled trials (RCTs) comparing creatine versus placebo for Parkinson's disease.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected the trials for inclusion, assessed trial quality and extracted data.
MAIN RESULTS
We included two RCTs with a total of 194 patients. Both trials compared creatine with placebo for Parkinson's disease and both had methodological limitations. There was no clear evidence of an effect on motor function (MD -0.26; 95% confidence interval (CI) -4.39 to 3.88, low quality evidence), activities of daily living (MD 0.37; 95% CI -1.28 to 2.02, low quality evidence) or quality of life after one or two years of treatment. One trial reported serious adverse events that were not attributed to creatine. Also, one trial observed higher rates of gastrointestinal effects at two years follow-up.
AUTHORS' CONCLUSIONS
The evidence base on the effects of creatine in Parkinson's disease is limited by risk of bias, small sample sizes and short duration of the eligible trials. It does not provide a reliable basis on which treatment decisions can be made. Future well-designed RCTs with larger sample size and long-term follow-up are needed to assess creatine for Parkinson's disease.
Topics: Activities of Daily Living; Creatine; Humans; Neuroprotective Agents; Parkinson Disease; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 24934384
DOI: 10.1002/14651858.CD009646.pub2 -
BMJ Clinical Evidence Jul 2008Up to 80% of people with cancer experience pain at some time during their illness, and most will need opioid analgesics. This review assesses how different opioid... (Review)
Review
INTRODUCTION
Up to 80% of people with cancer experience pain at some time during their illness, and most will need opioid analgesics. This review assesses how different opioid analgesics compare, in terms of both pain control and adverse effects, in people with cancer.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: what are the effects of opioids in treating cancer-related pain? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 22 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: codeine, dihydrocodeine, transdermal fentanyl, hydromorphone, methadone, morphine, oxycodone, and tramadol.
Topics: Administration, Oral; Analgesics; Analgesics, Opioid; Codeine; Fentanyl; Humans; Methadone; Neoplasms; Oxycodone; Pain
PubMed: 19445735
DOI: No ID Found -
Medicina (Kaunas, Lithuania) Feb 2023: Metformin has been found to potentially reduce the risk and improve the prognosis of a variety of tumors, but these findings remain controversial in biliary tract... (Meta-Analysis)
Meta-Analysis Review
: Metformin has been found to potentially reduce the risk and improve the prognosis of a variety of tumors, but these findings remain controversial in biliary tract cancer (BTC). Therefore, this systematic review and meta-analysis was conducted to investigate the association between metformin and BTC. : Two independent researchers comprehensively searched PubMed, Embase, the Cochrane Library, and Web of Science for eligible studies published from their inception to 31 March 2022. Comparisons of risk, overall survival (OS), and disease-free survival (DFS) for patients with BTC were selected as the endpoints of interest and pooled by random or fixed-effects models. : Eleven studies with a total of 24,788,738 participants were eligible for this analysis. The overall pooled effects showed no significant differences in biliary tract cancer risk (hazard ratio (HR) = 0.82, 95% confidence interval (CI): 0.50-1.35, = 0.436), OS (HR = 0.88, 95% CI: 0.74-1.04, = 0.135), or DFS (HR = 1.03, 95% CI: 0.79-1.34, = 0.829) between metformin users and non-users. When restricting participants to those with diabetes, a similar negative result was found, demonstrating that metformin use was not significantly associated with a lower risk of developing BTC compared with a lack of metformin use (HR = 0.65, 95% CI: 0.39-1.07, = 0.089); notably, the included studies exhibited significant heterogeneity in the selection of participants and the definition of metformin users. : Metformin may not be able to reduce the risk of BTC and improve prognosis in certain populations. Based on the limited quantity and quality of the included studies, the present results should be interpreted within their limitations, and further studies are warranted to determine the optimal timing, dose, duration, and scenario of metformin administration.
Topics: Humans; Metformin; Hypoglycemic Agents; Prognosis; Diabetes Mellitus; Biliary Tract Neoplasms
PubMed: 36837499
DOI: 10.3390/medicina59020298 -
BMJ Open Jun 2017To investigate the effectiveness of different treatments for gestational diabetes mellitus (GDM). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To investigate the effectiveness of different treatments for gestational diabetes mellitus (GDM).
DESIGN
Systematic review, meta-analysis and network meta-analysis.
METHODS
Data sources were searched up to July 2016 and included MEDLINE and Embase. Randomised trials comparing treatments for GDM (packages of care (dietary and lifestyle interventions with pharmacological treatments as required), insulin, metformin, glibenclamide (glyburide)) were selected by two authors and double checked for accuracy. Outcomes included large for gestational age, shoulder dystocia, neonatal hypoglycaemia, caesarean section and pre-eclampsia. We pooled data using random-effects meta-analyses and used Bayesian network meta-analysis to compare pharmacological treatments (ie, including treatments not directly compared within a trial).
RESULTS
Forty-two trials were included, the reporting of which was generally poor with unclear or high risk of bias. Packages of care varied in their composition and reduced the risk of most adverse perinatal outcomes compared with routine care (eg, large for gestational age: relative risk0.58 (95% CI 0.49 to 0.68; I=0%; trials 8; participants 3462). Network meta-analyses suggest that metformin had the highest probability of being the most effective treatment in reducing the risk of most outcomes compared with insulin or glibenclamide.
CONCLUSIONS
Evidence shows that packages of care are effective in reducing the risk of most adverse perinatal outcomes. However, trials often include few women, are poorly reported with unclear or high risk of bias and report few outcomes. The contribution of each treatment within the packages of care remains unclear. Large well-designed and well-conducted trials are urgently needed.
TRIAL REGISTRATION NUMBER
PROSPERO CRD42013004608.
Topics: Bayes Theorem; Cesarean Section; Diabetes, Gestational; Female; Glyburide; Humans; Hypoglycemic Agents; Insulin; Metformin; Pregnancy; Pregnancy Outcome; Randomized Controlled Trials as Topic
PubMed: 28647726
DOI: 10.1136/bmjopen-2016-015557 -
British Journal of Anaesthesia Apr 2022
Meta-Analysis
Topics: Diabetes Mellitus, Type 2; Humans; Hypoglycemic Agents; Metformin
PubMed: 35090726
DOI: 10.1016/j.bja.2022.01.001 -
Reproductive Biology and Endocrinology... Mar 2023Polycystic ovarian syndrome (PCOS) is one of the most common causes of infertility in reproductive-age women. However, the efficacy and optimal therapeutic strategy for... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Polycystic ovarian syndrome (PCOS) is one of the most common causes of infertility in reproductive-age women. However, the efficacy and optimal therapeutic strategy for reproductive outcomes are still under debate. We conducted a systematic review and network meta-analysis to compare the efficacy of different first-line pharmacological therapies in terms of reproductive outcomes for women with PCOS and infertility.
METHODS
A systematic retrieval of databases was conducted, and randomized clinical trials (RCTs) of pharmacological interventions for infertile PCOS women were included. The primary outcomes were clinical pregnancy and live birth, and the secondary outcomes were miscarriage, ectopic pregnancy and multiple pregnancy. A network meta-analysis based on a Bayesian model was performed to compare the effects of the pharmacological strategies.
RESULTS
A total of 27 RCTs with 12 interventions were included, and all therapies tended to increase clinical pregnancy, especially pioglitazone (PIO) (log OR 3.14, 95% CI 1.56 ~ 4.70, moderate confidence), clomiphene citrate (CC) + exenatide (EXE) (2.96, 1.07 ~ 4.82, moderate confidence) and CC + metformin (MET) + PIO (2.82, 0.99 ~ 4.60, moderate confidence). Moreover, CC + MET + PIO (2.8, -0.25 ~ 6.06, very low confidence) could increase live birth most when compared to placebo, even without a significant difference. For secondary outcomes, PIO showed a tendency to increase miscarriage (1.44, -1.69 ~ 5.28, very low confidence). MET (-11.25, -33.7 ~ 0.57, low confidence) and LZ + MET (-10.44, -59.56 ~ 42.11, very low confidence) were beneficial for decreasing ectopic pregnancy. MET (0.07, -4.26 ~ 4.34, low confidence) showed a neutral effect in multiple pregnancy. Subgroup analysis demonstrated no significant difference between these medications and placebo in obese participants.
CONCLUSIONS
Most first-line pharmacological treatments were effective in improving clinical pregnancy. CC + MET + PIO should be recommended as the optimal therapeutic strategy to improve pregnancy outcomes. However, none of the above treatments had a beneficial effect on clinical pregnancy in obese PCOS.
TRIAL REGISTRATION
CRD42020183541; 05 July 2020.
Topics: Female; Pregnancy; Humans; Network Meta-Analysis; Abortion, Spontaneous; Polycystic Ovary Syndrome; Infertility, Female; Clomiphene; Live Birth; Metformin; Obesity; Pioglitazone; Randomized Controlled Trials as Topic
PubMed: 36869381
DOI: 10.1186/s12958-023-01075-9