What the study found
Metformin was not associated with reduced seizure risk after a brain insult, but it was associated with lower seizure-related morbidity in people with established epilepsy who were already receiving antiseizure medications. The authors conclude that metformin could have repurposed benefits in epilepsy.
Why the authors say this matters
The study suggests metformin may have potential uses beyond diabetes, including possible benefit in epilepsy. The authors state that these findings warrant further investigation.
What the researchers tested
The researchers carried out an international retrospective cohort study using real-world healthcare data from TriNetX. They compared people without evidence of diabetes who received metformin with matched comparators taking licensed weight-management drugs, using propensity score matching and Cox proportional hazards models to estimate 10-year outcomes.
What worked and what didn't
After incident brain insults such as ischaemic stroke, intracranial haemorrhage, head injury, or brain tumour, metformin was not associated with lower risk of first recorded seizure, epilepsy diagnosis, or antiseizure medication initiation. In established epilepsy, metformin add-on was associated with significantly lower hazards of coded seizures, emergency attendance or hospital admission, falls/injuries/burns, and a composite outcome of these events. All-cause mortality did not differ.
What to keep in mind
This was a retrospective cohort study, so the abstract does not establish cause and effect. The findings are based on real-world data from TriNetX in people without evidence of diabetes, and the abstract does not describe other limitations.
Key points
- Metformin was not linked to lower risk of first seizure, epilepsy diagnosis, or antiseizure medication start after a brain insult.
- In established epilepsy, metformin add-on was linked to lower hazards of coded seizures and several seizure-related adverse events.
- The study compared metformin with licensed weight-management comparators in people without evidence of diabetes.
- All-cause mortality did not differ between groups.
- The authors say the findings warrant further investigation.
Disclosure
- Research title:
- Metformin was linked to better seizure-related outcomes in epilepsy
- Image credit:
- Photo by Towfiqu barbhuiya on Unsplash
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