Dewi Fathin Romdhoniyyah1, Simon P Harding2,3, Christopher P Cheyne4, Nicholas A V Beare2,3. 1. Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK. d.f.romdhoniyyah@liverpool.ac.uk. 2. Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK. 3. St. Paul's Eye Unit, Liverpool University Hospitals NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, UK. 4. Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool, UK.
Abstract
BACKGROUND: Currently, no generally approved medical treatment can delay the onset of age-related macular degeneration (AMD) or slow the progression of degenerative changes. Repurposing drugs with beneficial effects on AMD pathophysiology offers a route to new treatments which is faster, cost-effective, and safer for patients. Recent studies indicate a potential role for metformin in delaying AMD development and progression. In this context, we conducted a systematic review and meta-analysis to look for beneficial associations between metformin and AMD. METHODS: We systematically searched Medline and Embase (via Ovid), Web of Science, and ClinicalTrials.gov databases for clinical studies in humans that examined the associations between metformin treatment and AMD published from inception to February 2021. We calculated pooled odds ratio (OR) with 95% confidence interval (CI) considering a random effect model in the meta-analysis. RESULTS: Five retrospective studies met the inclusion criteria. There are no prospective studies that have reported the effect of metformin in AMD. The meta-analysis showed that people taking metformin were less likely to have AMD although statistical significance was not met (pooled adjusted OR = 0.80, 95% CI 0.54-1.05, I2 = 98.8%). Subgroup analysis of the association between metformin and early and late AMD could not be performed since the data was not available from the included studies. CONCLUSIONS: Analysis of retrospective data suggests a signal that metformin may be associated with decreased risk of any AMD. It should be interpreted with caution because of the failure to meet statistical significance, the small number of studies, and the limitation of routine record data. However prospective studies are warranted in generalizable populations without diabetes, of varied ethnicities, and AMD stages. Clinical trials are needed to determine if metformin has efficacy in treating early and late-stage AMD.
BACKGROUND: Currently, no generally approved medical treatment can delay the onset of age-related macular degeneration (AMD) or slow the progression of degenerative changes. Repurposing drugs with beneficial effects on AMD pathophysiology offers a route to new treatments which is faster, cost-effective, and safer for patients. Recent studies indicate a potential role for metformin in delaying AMD development and progression. In this context, we conducted a systematic review and meta-analysis to look for beneficial associations between metformin and AMD. METHODS: We systematically searched Medline and Embase (via Ovid), Web of Science, and ClinicalTrials.gov databases for clinical studies in humans that examined the associations between metformin treatment and AMD published from inception to February 2021. We calculated pooled odds ratio (OR) with 95% confidence interval (CI) considering a random effect model in the meta-analysis. RESULTS: Five retrospective studies met the inclusion criteria. There are no prospective studies that have reported the effect of metformin in AMD. The meta-analysis showed that people taking metformin were less likely to have AMD although statistical significance was not met (pooled adjusted OR = 0.80, 95% CI 0.54-1.05, I2 = 98.8%). Subgroup analysis of the association between metformin and early and late AMD could not be performed since the data was not available from the included studies. CONCLUSIONS: Analysis of retrospective data suggests a signal that metformin may be associated with decreased risk of any AMD. It should be interpreted with caution because of the failure to meet statistical significance, the small number of studies, and the limitation of routine record data. However prospective studies are warranted in generalizable populations without diabetes, of varied ethnicities, and AMD stages. Clinical trials are needed to determine if metformin has efficacy in treating early and late-stage AMD.
Authors: Frederick L Ferris; C P Wilkinson; Alan Bird; Usha Chakravarthy; Emily Chew; Karl Csaky; SriniVas R Sadda Journal: Ophthalmology Date: 2013-01-16 Impact factor: 12.079
Authors: Wan Ling Wong; Xinyi Su; Xiang Li; Chui Ming G Cheung; Ronald Klein; Ching-Yu Cheng; Tien Yin Wong Journal: Lancet Glob Health Date: 2014-01-03 Impact factor: 26.763
Authors: Seth R Flaxman; Rupert R A Bourne; Serge Resnikoff; Peter Ackland; Tasanee Braithwaite; Maria V Cicinelli; Aditi Das; Jost B Jonas; Jill Keeffe; John H Kempen; Janet Leasher; Hans Limburg; Kovin Naidoo; Konrad Pesudovs; Alex Silvester; Gretchen A Stevens; Nina Tahhan; Tien Y Wong; Hugh R Taylor Journal: Lancet Glob Health Date: 2017-10-11 Impact factor: 26.763
Authors: P Fernández-Robredo; A Sancho; S Johnen; S Recalde; N Gama; G Thumann; J Groll; A García-Layana Journal: J Ophthalmol Date: 2014-01-14 Impact factor: 1.909
Authors: Lidianys María Lewis Luján; Mark F McCarty; James J Di Nicolantonio; Juan Carlos Gálvez Ruiz; Ema Carina Rosas-Burgos; Maribel Plascencia-Jatomea; Simon Bernard Iloki Assanga Journal: Nutrients Date: 2022-05-09 Impact factor: 6.706
Authors: Shivam V Amin; Saira Khanna; Seyedeh P Parvar; Lincoln T Shaw; David Dao; Seenu M Hariprasad; Dimitra Skondra Journal: Exp Biol Med (Maywood) Date: 2022-01-22