SynthesisBMC rheumatology2026
Effectiveness of metformin as an adjunctive therapy in rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in BMC rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRheumatoid arthritis (RA) is a chronic inflammatory disease that impacts patients' quality of life. Evidence regarding the effectiveness of metformin use as an adjunct therapy in RA is limited and fragmented. This systematic review and meta-analysis aimed to evaluate the effectiveness of metformin as an adjunct therapy in RA and to quantitatively synthesize available evidence.
methodsThis systematic review and meta-analysis were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focusing on randomised controlled trials (RCTs) that assessed the effect of metformin as an adjunct therapy for patients with RA receiving conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). C-reactive protein (CRP), Disease Activity Score in 28 joints (DAS-2)8, and Health Assessment Questionnaire Disability Index (HAQ-DI) were included as an outcome. A search was conducted across four databases up to 31 December 2025, including PubMed, Embase, Cochrane Central, and Scopus. The methodological quality of the included RCTs was evaluated using risk of bias 2 (RoB 2) tool. Statistical analysis was conducted with StataNow version 19.5. For each outcome, pooled mean differences (MDs) with 95% confidence intervals (CIs) were estimated using random-effects models.
resultsA total of four RCTs with 350 participants were included in this review. The use of metformin was associated with significant decreases in several indicators after three months, including a reduction in the CRP level (MD = -5.55, 95% CI = -7.46 to -4.52, p-value = 0.00), DAS-28 (MD = -0.8, %CI = -0.87 to 0.73, p-value < 0.001), and HAQ-DI (MD =-0.12, %CI = -0.19 to -0.05, p-value < 0.001). Additionally, a significant reduction in CRP after six months (MD = -6.96, %95 CI = -7.79 to -6.13, p-value < 0.001) compared to the placebo group.
conclusionThis systematic review provides moderate-to-high certainty evidence supporting the use of metformin as an adjunctive therapy in RA. However, larger, longer-duration randomized trials are required to confirm these findings and improve generalizability.
Indexed as
Identifiers
What OpenQuestion holds
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.