ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0029

Effect of Metformin on the Incidence of Total Knee Replacement: A Systematic Review and Meta-Analysis

Syed Hasan1, Aali Furqan2, Afia Salman3, hira Khan4, Sarah Aslam5, Alishba Rizvi4, Hafsah Alim Ur Rahman3, Muhammad Ahmed Ali Fahim3, Madiha Salman3, Eman Ali3, Yumna Furqan6, Shanta bai7, Farah Yasmin8 and Muhammad Sohaib Asghar9, 1Dow University of Health Sciences, Karachi, PK., Karachi, Sindh, Pakistan, 2University of North Texas Health Science Center (UNT HSC), Texas, TX, 3Dow University of Health Sciences, Karachi, Pakistan, 4dow medical college, Karachi, Pakistan, 5Dow International Medical College, Karachi, Pakistan, 6Texas A&M School of Medicine, Dallas, TX, 7Liaquat National Hospital and Medical College, Karachi, Pakistan, 8Yale University School of Medicine, New Haven, CT 06511, U.S.A., New Haven, CT, 9AdventHealth, Sebring, FL

Meeting: ACR Convergence 2024

Keywords: , ,

Session Information

Date: Saturday, November 16, 2024

Title: Osteoarthritis & Joint Biology – Basic Science Poster

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: Osteoarthritis (OA) is among the most common debilitating conditions, causing disability and pain in older adults. For end-stage OA, total knee replacement (TKR) is a common surgical modality deployed in patients with OA. Some studies have highlighted the prevalence of knee osteoarthritis in people with type 2 diabetes (T2DM). Considering that metformin is one of the most prescribed diabetic medications worldwide and has proved to be associated with weight loss, anti-inflammatory, chondroprotective as well as improved insulin resistance properties, we sought to assess the effect of metformin and the risk of TKR by performing this meta-analysis.

Methods: MEDLINE/PubMed, Cochrane Library, Embase, SCOPUS, and ClinicalTrials.gov were searched from inception to May 2024. Studies were eligible if they included “metformin”, “total knee replacement”, and “total knee arthroplasty” along with a description of the effect of metformin on the reduction of risk of TKR in patients with T2DM. The Newcastle-Ottawa Scale (NOS) tool was employed for the assessment of risk of bias in non-randomized studies.

Results: A total of 4 studies with a total of 115,182 participants, were included in our analysis. The median duration of the studies was 11 (9-15.4) years. Our primary outcome of interest was TKR. Pooled data from all four studies showed a significant decrease in the risk of TKR associated with metformin use (RR: 0.59; 95% CI: 0.38 to 0.90; P=0.02; I2:86%) (Figure 1). The heterogeneity declined upon odd-one-out analysis (RR: 0.82; 95% CI: 0.71 to 0.93; P=0.003; I2: 0%). Moreover, upon conducting the meta-regression, males were significantly associated with a greater incidence of TKR under Metformin use when compared with females (coefficient: 0.0498).

Conclusion: In patients with T2DM, regular use of metformin showed a significant decrease in the risk of TKR. Males under Metformin therapy were comparably associated with higher incidence of TKR when compared with females. The certainty of our findings is limited to the paucity of the available data that explores the relationship between Metformin and TKR.

Supporting image 1

Forest plot for Total Knee Replacement among patients under Metformin therapy vs. Non-Metformin therapy.

Disclosures: S. Hasan: None; A. Furqan: None; A. Salman: None; h. Khan: None; S. Aslam: None; A. Rizvi: None; H. Alim Ur Rahman: None; M. Fahim: None; M. Salman: None; E. Ali: None; Y. Furqan: None; S. bai: None; F. Yasmin: None; M. Asghar: None.

To cite this abstract in AMA style:

Hasan S, Furqan A, Salman A, Khan h, Aslam S, Rizvi A, Alim Ur Rahman H, Fahim M, Salman M, Ali E, Furqan Y, bai S, Yasmin F, Asghar M. Effect of Metformin on the Incidence of Total Knee Replacement: A Systematic Review and Meta-Analysis [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/effect-of-metformin-on-the-incidence-of-total-knee-replacement-a-systematic-review-and-meta-analysis/. Accessed .

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/effect-of-metformin-on-the-incidence-of-total-knee-replacement-a-systematic-review-and-meta-analysis/