Update on metformin for osteoarthritis treatment

Inflammopharmacology. 2025 Oct;33(10):5963-5975. doi: 10.1007/s10787-025-01902-y. Epub 2025 Sep 25.

Abstract

Osteoarthritis (OA) is a prevalent degenerative joint disease among middle-aged and elderly individuals. Metabolic syndrome (Met S), a group of clinical conditions characterized by abnormal metabolic processes, includes obesity as one of its primary risk factors. Recent studies have demonstrated a significant association between metabolic syndrome and osteoarthritis. Metformin, a classical hypoglycemic agent, is commonly prescribed for patients with type 2 diabetes mellitus who do not achieve adequate control through diet and physical activity alone. Metformin has gradually gained attention in the treatment of OA due to its anti-inflammatory, antioxidant, and metabolic function-enhancing properties. This review summarizes the latest research on metformin by examining recent clinical and animal studies, systematically analyzing its mechanisms, and assessing its clinical potential in treating OA.

Keywords: Anti-catabolism; Anti-inflammatory effect; Inflammatory mediators; Metabolic syndrome; Metformin; Osteoarthritis.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / pharmacology
  • Anti-Inflammatory Agents / therapeutic use
  • Antioxidants / pharmacology
  • Antioxidants / therapeutic use
  • Diabetes Mellitus, Type 2 / drug therapy
  • Humans
  • Hypoglycemic Agents* / pharmacology
  • Hypoglycemic Agents* / therapeutic use
  • Metabolic Syndrome / drug therapy
  • Metformin* / pharmacology
  • Metformin* / therapeutic use
  • Osteoarthritis* / drug therapy
  • Osteoarthritis* / metabolism

Substances

  • Metformin
  • Hypoglycemic Agents
  • Antioxidants
  • Anti-Inflammatory Agents