ArticleThe journal of allergy and clinical immunology. In practice2021
Metformin Use and Risk of Asthma Exacerbation Among Asthma Patients with Glycemic Dysfunction.
Article in The journal of allergy and clinical immunology. In practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Metformin use & asthma outcomes in patients with concurrent diabetes & bronchial asthma: A systematic review & meta-analysis.The Indian journal of medical research · 2025 · on this mapPooled it
- It's more than mechanics: the case for metabolic end-points in airways disease.The European respiratory journal · 2026Review
- Immunometabolic Modulation in Obese Asthma: How GLP-1 Receptor Agonists Could Influence Systemic and Pulmonary Immune Phenotypes.Pulmonary therapy · 2026Review
- Mechanisms and therapeutic strategies of asthma: from bench to bedside.Signal transduction and targeted therapy · 2026Review
- Type 2 Diabetes and the Lung - Cause and Consequence.Current diabetes reports · 2026Review
- Metformin for asthma exacerbations.The Cochrane database of systematic reviews · 2026Article
- Hyperglycemia, receptor for advanced glycation end products, and small airways dysfunction in asthma.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2026Article
- Antidiabetic drug and chronic respiratory disease in type 2 diabetes: a network meta-analysis and Mendelian randomization analysis.Therapeutic advances in endocrinology and metabolism · 2026Review
- Effects of metabolic syndrome on pulmonary infection in pediatric bronchial asthma: a narrative review.Frontiers in pediatrics · 2026Review
- The central role of IL-6 in the differential effects of GLP-1 receptor agonists and metformin across multiple health conditions.Frontiers in immunology · 2026Review
- Metabolic licensing at the dendritic cell-NK cells immune synapse in viral asthma exacerbations.Frontiers in immunology · 2026Review
- Inflammatory Dysregulation, Asthma, and Obesity in Children: What is the Relationship?Journal of inflammation research · 2026Review
- Metformin use is associated with reduced systemic steroid courses among pediatric asthma patients with diabetes or elevated blood glucose levels.Respiratory medicine · 2025 · on this mapObservational
- Metformin effects on respiratory and metabolic outcomes in asthma and metabolic syndrome: a double-blind, randomized, placebo-controlled clinical trial.Annals of medicine and surgery (2012) · 2025Article
- Non-T2 asthma.Current opinion in pulmonary medicine · 2025Review
- The role of type 2 diabetes in the severity of adult asthma.Current opinion in allergy and clinical immunology · 2025Review
- Corticosteroid insensitivity in obese asthma: potential mechanisms and therapeutic perspectives.Frontiers in allergy · 2025Review
- Obesity-related Asthma: A Pathobiology-based Overview of Existing and Emerging Treatment Approaches.American journal of respiratory and critical care medicine · 2024Review
- Weighted Breaths: Exploring Biologic and Non-Biologic Therapies for Co-Existing Asthma and Obesity.Current allergy and asthma reports · 2024Review
- TRP channels associated with macrophages as targets for the treatment of obese asthma.Lipids in health and disease · 2024Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundDiabetes is associated with worse asthma morbidity. Metformin, which treats diabetes, may have a role among patients with asthma and glycemic dysfunction.
objectiveTo determine the association between metformin use and asthma exacerbations among patients with diabetes.
methodsWe queried the Johns Hopkins electronic health record from April 1, 2013, to May 31, 2018. Adults with asthma and diabetes were followed from first hemoglobin A1c (HbA1c) test to an asthma-related systemic corticosteroid prescription, emergency department (ED) visit, or hospitalization. Multivariable Cox models estimated time to each outcome associated with metformin use, modeled as either time-invariant (status at HbA1c testing) or time-dependent (based on fill data). Mediation of results by HbA1c was assessed. Sensitivity analysis was performed by propensity score matching.
resultsThe cohort comprised 1749 adults with asthma and diabetes. Metformin use at entry was associated with a lower hazard of asthma-related ED visits (adjusted hazard ratio [aHR], 0.40; 95% CI, 0.22-0.75) but not steroid prescription (aHR, 0.89; 95% CI, 0.70-1.13) or hospitalization (aHR, 0.38; 95% CI, 0.13-1.12). HbA1c did not mediate the association with ED visits. With metformin exposure modeled as time-dependent, metformin use was additionally associated with lower hazard of asthma-related hospitalization (aHR, 0.30; 95% CI, 0.09-0.93). Results were consistent within a subcohort of 698 metformin users matched 1:1 to nonusers by propensity score.
conclusionsMetformin use, independent of glycemic control and obesity, was associated with lower hazard of asthma-related ED visits and hospitalizations. Metformin may have benefit in patients with asthma and glycemic dysfunction.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.