ReviewArab journal of urology2026
The safety and efficacy of metformin on metabolic syndrome parameters in prostate cancer patients receiving androgen deprivation therapy: A systematic review and meta-analysis.
Review in Arab journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Abstract
Background: Prostate cancer patients are more likely to develop metabolic syndrome because androgen deprivation therapy (ADT), a standard treatment for advanced prostate cancer, causes major metabolic syndrome components and associated disorders. Metformin, a low-cost oral antidiabetic with a favorable safety profile, may be useful for preventing metabolic issues associated with ADT. This meta-analysis aims to assess the efficacy and safety of metformin on metabolic syndrome parameters in prostate cancer patients receiving ADT. Methods: In November 2025, we conducted a systematic search of PubMed, Scopus, and the Cochrane Library for randomized and non-randomized controlled trials. Studies were considered eligible if they included adult men (≥18 years) with prostate cancer receiving ADT and assessed metformin versus placebo/standard care on metabolic outcomes. For the meta-analysis, we used R 4.5.0 with R Studio 2024.12.1+563 using a random-effects mode. Results: We included ten trials with a total sample size of 2,642 patients. There were no significant differences in HbA1c (MD = -0.01, 95% CI -0.1; 0.2, P = 0.8), body weight (MD = 0.42, 95% CI -3.31; 4.16, P = 0.8), body mass index (MD = -0.01, 95% CI -0.1; 0.2, P = 0.8), or waist circumference (MD = -1.67, 95% CI -4.6; 1.26, P = 0.26). There was no significant difference in blood pressure, fasting glucose, triglycerides, or HDL cholesterol levels. Metformin was well tolerated but was related with a greater risk of diarrhea (RR = 2.55, 95% CI 1.02; 6.39). The Trial sequential analysis (TSA) stated that the current evidence is insufficient and underpowered. Conclusion: According to our data, metformin did not provide a substantial improvement in metabolic syndrome indices for prostate cancer patients on ADT. Its efficacy as a stand-alone remedy appears to be limited. Future large-scale clinical trials should investigate the role of metformin in combination with structured lifestyle changes.
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