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Efficacy and Safety of Metformin for Obesity: A Systematic Review.

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Title: Efficacy and Safety of Metformin for Obesity: A Systematic Review.
Authors: Masarwa, Reem, Brunetti, Vanessa C., Aloe, Stephanie, Henderson, Mélanie, Platt, Robert W., Filion, Kristian B.
Source: Pediatrics. Mar2021, Vol. 147 Issue 3, p1-15. 15p.
Subjects: Drug efficacy, Safety, Online information services, Lifestyles, Homeostasis, Medical information storage & retrieval systems, Medical databases, Information storage & retrieval systems, Childhood obesity, Systematic reviews, Gastrointestinal diseases, Treatment effectiveness, Descriptive statistics, Metformin, MEDLINE, Body mass index, Insulin resistance, Evaluation
Abstract: CONTEXT: The efficacy and safety of metformin for obesity in children and adolescents remains unclear. OBJECTIVE: To assess the efficacy and safety of metformin via systematic review. DATA SOURCES: Data sources included PubMed, Embase, the Cochrane Library, Scopus, and ClincalTrials.gov (inception to November 2019). STUDY SELECTION: We selected randomized controlled trials (RCTs) in which researchers assessed the efficacy and safety of metformin with lifestyle interventions, compared with a placebo with lifestyle interventions, in children and adolescents with obesity. DATA EXTRACTION: Two researchers independently extracted data and assessed quality. The primary outcomes were mean changes from baseline in BMI, BMI z score, homeostatic model assessment of insulin resistance, and gastrointestinal adverse effects. RESULTS:Twenty-four RCTs (1623 patients; range: 16 to 151) were included. Ages ranged from 4 to 19 years, and follow-up ranged from 2 months to 2 years. Metformin resulted in a modest decrease in BMI (range of mean values: 22.70 to 1.30 vs 21.12 to 1.90), BMI z score (range of mean values: 20.37 to 20.03 vs 20.22 to 0.15), and homeostatic model assessment of insulin resistance (range of mean values: 23.74 to 1.00 vs 21.40 to 2.66). Metformin resulted in a higher frequency of gastrointestinal adverse effects (range: 2% to 74% vs 0% to 42%). LIMITATIONS: The available evidence is of varying quality, with high heterogeneity between trials, suggesting some uncertainty in the benefits of metformin in this population. CONCLUSIONS: With this systematic review of RCTs, we suggest that metformin has modest but favorable effects on weight and insulin resistance and a tolerable safety profile among children and adolescents with obesity. [ABSTRACT FROM AUTHOR]
Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Efficacy and Safety of Metformin for Obesity: A Systematic Review.
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  Data: <searchLink fieldCode="JN" term="%22Pediatrics%22">Pediatrics</searchLink>. Mar2021, Vol. 147 Issue 3, p1-15. 15p.
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– Name: Abstract
  Label: Abstract
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  Data: CONTEXT: The efficacy and safety of metformin for obesity in children and adolescents remains unclear. OBJECTIVE: To assess the efficacy and safety of metformin via systematic review. DATA SOURCES: Data sources included PubMed, Embase, the Cochrane Library, Scopus, and ClincalTrials.gov (inception to November 2019). STUDY SELECTION: We selected randomized controlled trials (RCTs) in which researchers assessed the efficacy and safety of metformin with lifestyle interventions, compared with a placebo with lifestyle interventions, in children and adolescents with obesity. DATA EXTRACTION: Two researchers independently extracted data and assessed quality. The primary outcomes were mean changes from baseline in BMI, BMI z score, homeostatic model assessment of insulin resistance, and gastrointestinal adverse effects. RESULTS:Twenty-four RCTs (1623 patients; range: 16 to 151) were included. Ages ranged from 4 to 19 years, and follow-up ranged from 2 months to 2 years. Metformin resulted in a modest decrease in BMI (range of mean values: 22.70 to 1.30 vs 21.12 to 1.90), BMI z score (range of mean values: 20.37 to 20.03 vs 20.22 to 0.15), and homeostatic model assessment of insulin resistance (range of mean values: 23.74 to 1.00 vs 21.40 to 2.66). Metformin resulted in a higher frequency of gastrointestinal adverse effects (range: 2% to 74% vs 0% to 42%). LIMITATIONS: The available evidence is of varying quality, with high heterogeneity between trials, suggesting some uncertainty in the benefits of metformin in this population. CONCLUSIONS: With this systematic review of RCTs, we suggest that metformin has modest but favorable effects on weight and insulin resistance and a tolerable safety profile among children and adolescents with obesity. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1542/peds.2020-1610
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      – Code: eng
        Text: English
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        PageCount: 15
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    Subjects:
      – SubjectFull: Drug efficacy
        Type: general
      – SubjectFull: Safety
        Type: general
      – SubjectFull: Online information services
        Type: general
      – SubjectFull: Lifestyles
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      – SubjectFull: Homeostasis
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      – SubjectFull: Medical information storage & retrieval systems
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      – SubjectFull: Metformin
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              Text: Mar2021
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