Metformin Lowers Gout Risk in Pre-Diabetes Save

A large, propensity score-matched cohort study shows that metformin use in patients with pre-diabetes significantly lowers the risk of future gout. 

Metformin is widely used for diabetes and pre-diabetes. Importantly, its use has been linked with a lower risk of osteoarthritis, rheumatoid arthritis, and possibly gout. This study examined the drugs use in a cohort of pre-diabetes patients, without a gout history, do assess its effect on future incident gout.

A single academic center, EHR study of pre-diabetics matched new-users of metformin to those not starting new therapy. Pre-diabetes was defined based on haemoglobin A1c levels. The primary outcome was incident gout. 

Froma total of 25 064 pre-diabetics, they and propensity score-matched 1154 metformin initiators to 13 877 non-users. After a median follow-up of 3.9 years, the incidence of gout was significantly lower in metformin users  (HR 0.68, 95% CI 0.48 to 0.96).

• Metformin treated: 7.1 per 1000 person-years

• Untreated: 9.5 per 1000 person-years 

Metformin had no effect on uric acid or CRP levels.

There's a curious linkage between gout and diabetes and the components of the metabolic syndrome. It therefore comes as no surprise that metformin is effective pre-diabetes, but may also lower gout risk in individuals with pre-diabetes.