{Reference Type}: Journal Article
{Title}: Repurposing metformin as adjuvant therapy in patients with ulcerative colitis treated with mesalamine: A randomized controlled double-blinded study.
{Author}: El-Haggar SM;Hegazy SK;Maher MM;Bahgat MM;Bahaa MM;
{Journal}: Int Immunopharmacol
{Volume}: 138
{Issue}: 0
{Year}: 2024 Sep 10
{Factor}: 5.714
{DOI}: 10.1016/j.intimp.2024.112541
{Abstract}: <B>BACKGROUND: </B>Ulcerative colitis (UC) is a type of inflammatory bowel disease associated with persistent inflammation. Animal studies proved the efficacy of metformin in UC.<BR><B>OBJECTIVE: </B>To investigate the potential role of metformin and its protective pathways in patients with UC.<BR><B>METHODS: </B>This is a randomized, controlled, and double-blinded clinical trial that included 60 participants with mild to moderate UC and was divided randomly into two groups (n = 30). For 6 months, the mesalamine group received 1 g of mesalamine three times daily (t.i.d.). For six months, the metformin group received mesalamine 1 g t.i.d. and metformin 500 mg twice daily. A gastroenterologist evaluated patients at baseline and 6 months after starting the treatment in order to measure serum levels of zonulin, sphingosine 1 phosphate (S1P), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Biopsies from the colon were used to measure gene expression of zonula occuldin-1 (ZO-1), signal transducer and activator of factor-3 (STAT-3), and intracellular adhesion molecule-1 (ICAM-1). The numeric pain rating scale (NRS) and partial Mayo score were also assessed for each patient.<BR><B>RESULTS: </B>When compared to the mesalamine group, the metformin group demonstrated a statistical decrease in serum IL-6, zonulin, TNF-α, SIP, gene expression of ICAM-1 and STAT-3, and a significant increase in colonic ZO-1 when compared to the mesalamine group. The metformin group also showed a significant decrease in NRS and partial Mayo score index in comparison with the mesalamine group.<BR><B>CONCLUSIONS: </B>Metformin may be a promising additional therapy for UC patients. Trial registration identifier: NCT05553704.