Metformin may improve clinical outcomes in patients with idiopathic pulmonary fibrosis (IPF) and type 2 diabetes mellitus, a new study published in Respiratory Research found. More research is needed, however, before metformin can be used to manage IPF in the clinic, the authors said.

Previous studies have shown that metformin, the first-line treatment for the management of type 2 diabetes, may have antifibrotic properties, but real-world clinical data about its potential effectiveness in IPF is scarce.

Here, a team of researchers led by Andrew H. Limper, MD, from the Mayo Clinic conducted a nationwide cohort study to evaluate the clinical benefit of metformin in patients with IPF and type 2 diabetes.

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Using data from OptumLabs® Data Warehouse, the researchers identified 3599 patients with IPF and type 2 diabetes mellitus. Of those, 1377 were treated with metformin while 2222 were not. Following matched analysis, the researchers found that treatment with metformin was associated with a reduction in all-cause mortality and hospitalizations compared to no treatment.

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“While these results are intriguing, caution is encouraged,” the researcher wrote. “Specific recommendations for the clinical management of [IPF] will require further investigation, including randomized clinical trials that ideally delineate between cardiovascular protection, disease stabilization, and improvement in the course of fibrosis by utilizing objective measures such as pulmonary function testing and thoracic imaging.”

IPF is a chronic and progressive lung disease, symptoms of which include dyspnea and chronic, unproductive cough. The exact cause of the disease is not known but a number of environmental, genetic, and epigenetic factors are known to contribute to its development. Type 2 diabetes mellitus is a common comorbidity of IPF, and others include gastroesophageal reflux disease, emphysema, pulmonary hypertension, cardiovascular disease, lung cancer, hiatal hernia, and hypothyroidism.


Teague TT, Payne SR, Kelly BT, et al. Evaluation for clinical benefit of metformin in patients with idiopathic pulmonary fibrosis and type 2 diabetes mellitus: a national claims-based cohort analysis. Respir Res. 2022;23(1):91. doi:10.1186/s12931-022-02001-0