The efficacy of metformin for pain, function, and quality of life in knee osteoarthritis: A systematic review and meta-analysis
Pooled result · Pain scoresResult — go to the resultSMD −1.295 95 % CI −2.063 to −0.526Authors' conclusion
While metformin demonstrated consistent benefits in pain and functional outcomes, these findings should be interpreted as symptomatic and adjunctive effects rather than definitive disease modification.
Study context
- Population
- Patients with knee OA; RCTs from PubMed, Embase and Cochrane Library up to May 2025
- Participants
- 337 patients5 studies
- Comparison
- Metformin vs control
- Outcome
- Pain scores
Methodological detailsrandom-effects model, subgroup analyses by formulation, treatment duration and NSAID co-administration
- Random-effects model
- Subgroup analyses by formulation, treatment duration and NSAID co-administration
Pooled result
As reported in the abstract
SMD
−1.295
95 % CI −2.063 to −0.526
Metforminvs control
SMD −1.295 (95 % CI −2.063 to −0.526)
Further pooled results
Stiffness
| SMD (95 % CI) | ||
|---|---|---|
| Metformin | −0.746 (−1.385 to −0.107) | |
| −2−101Difference (linear scale) |
Physical function (improved)
| SMD (95 % CI) | ||
|---|---|---|
| Metformin | −2.042 (−3.372 to −0.712) | |
| −4−202Difference (linear scale) |
Health-related quality of life (improved)
| SMD (95 % CI) | ||
|---|---|---|
| Metformin | −1.505 (−2.896 to −0.115) | |
| −4−202Difference (linear scale) |
Subgroups by formulation, treatment duration and NSAID use
- Effects consistent regardless of oral or topical metformin use, treatment duration, and NSAID use; benefits greater when combined with nonsteroidal anti-inflammatory drugs (NSAIDs)
Original publication
The efficacy of metformin for pain, function, and quality of life in knee osteoarthritis: A systematic review and meta-analysis. Semin Arthritis Rheum. Published 31 December 2025. doi:10.
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