SynthesisThe Indian journal of medical research2025
Metformin use & asthma outcomes in patients with concurrent diabetes & bronchial asthma: A systematic review & meta-analysis.
Synthesis in The Indian journal of medical research, 2025. The graph read 5 numbers from its abstract, feeding 2 cells of the map, but none could be read as for or against, so it casts no vote. It also reports 2 associations that do not count as treatment evidence, such as HR 0.89 (0.83 to 0.97) for asthma exacerbation. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
Read, but not usablea number the graph found but could not read as for or against
The two groups also had statistically identical risks of asthma-related hospitalisations (HR 0.76, 95% CI: 0.54, 1.07, P=0.12) and use of rescue steroids (HR 0.95, 95% CI: 0.87, 1.03, P=0.24).
The two groups also had statistically identical risks of asthma-related hospitalisations (HR 0.76, 95% CI: 0.54, 1.07, P=0.12) and use of rescue steroids (HR 0.95, 95% CI: 0.87, 1.03, P=0.24).
However, after excluding a study from Taiwan (n=115486), a significantly lower risk of asthma exacerbation (HR 0.89, 95% CI: 0.83-0.97, P=0.005) and asthma-related hospitalisations (HR 0.68, 95% CI: 0.49-0.93, P=0.02) was observed in MU.
The risk of asthma-related emergency room visits appeared lower in MU than in non-MU, though the difference did not gain statistical significance (HR 0.63, 95% CI: 0.39, 1.01, P=0.06).
However, after excluding a study from Taiwan (n=115486), a significantly lower risk of asthma exacerbation (HR 0.89, 95% CI: 0.83-0.97, P=0.005) and asthma-related hospitalisations (HR 0.68, 95% CI: 0.49-0.93, P=0.02) was observed in MU.
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Where it lands on the map
Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.
What it adds to each cell
For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.
Metformin×adverse events & safety
No readable resultOpen on the map →What to test next →22 readable studies in this cell: 9 favour the treatment, 8 find no difference, 5 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Metformin×costs & health-care use
No readable resultOpen on the map →What to test next →1 readable study in this cell: 0 favour the treatment, 1 find no difference, 0 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- The central role of IL-6 in the differential effects of GLP-1 receptor agonists and metformin across multiple health conditions.Frontiers in immunology · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The marked sentences are the ones the graph read a number from.
Background & objectives Limited data exist on the effects of metformin on asthma outcomes in patients having type 2 diabetes (T2D) along with asthma. This meta-analysis seeks to determine whether metformin influences asthma outcomes in these patients. Methods Studies involving adults with T2D and asthma, using metformin in the intervention group and other glucose-lowering drugs in the control group, were systematically searched through databases. The primary outcome was the adjusted risk of asthma exacerbations in metformin users (MU) vs. non-metformin users (non-MU). Other outcomes included asthma-related emergency room visits, hospitalisations, and the need for rescue steroids. Meta-analysis was conducted using RevMan with random-effects models. Outcomes were reported as hazard ratios (HRs) with 95 per cent confidence intervals (95% CI). Results Six retrospective cohort studies with moderate overall risk of bias, involving 317,905 patients, were included. The risk of asthma exacerbation was comparable in MU and non-MU (HR 0.95, 95% CI: 0.86, 1.04, P=0.27). The risk of asthma-related emergency room visits appeared lower in MU than in non-MU, though the difference did not gain statistical significance (HR 0.63, 95% CI: 0.39, 1.01, P=0.06). The two groups also had statistically identical risks of asthma-related hospitalisations (HR 0.76, 95% CI: 0.54, 1.07, P=0.12) and use of rescue steroids (HR 0.95, 95% CI: 0.87, 1.03, P=0.24). However, after excluding a study from Taiwan (n=115486), a significantly lower risk of asthma exacerbation (HR 0.89, 95% CI: 0.83-0.97, P=0.005) and asthma-related hospitalisations (HR 0.68, 95% CI: 0.49-0.93, P=0.02) was observed in MU. Interpretation & conclusions Metformin therapy for T2D does not influence asthma outcomes; however, certain outcomes appear to improve when a Taiwanese study is excluded. Such results must be considered cautiously, as the included studies are observational and have a moderate risk of bias. Randomised controlled trials with diverse global representation are essential for clarifying the relationship between metformin use and asthma outcomes.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.