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Metformin Beneficial for Osteoarthritis Knee Pain in Overweight, Obesity

By Elana Gotkine HealthDay Reporter

Medically reviewed by Carmen Pope, BPharm. Last updated on May 1, 2025.

via HealthDay

THURSDAY, May 1, 2025 -- For patients with overweight or obesity and symptomatic knee osteoarthritis, metformin is associated with a greater improvement in knee pain than placebo, according to a study published online April 24 in the Journal of the American Medical Association to coincide with the 2025 Osteoarthritis Research Society World Congress, held from April 24 to 27 in Incheon, South Korea.

Feng Pan, Ph.D., from the School of Public Health and Preventive Medicine at Monash University in Melbourne, Australia, and colleagues examined the effects of metformin on knee pain at six months among patients with symptomatic knee osteoarthritis and overweight or obesity. Participants were recruited and followed remotely using telemedicine. Individuals with knee pain for six months or longer, a pain score of 40 mm on a 100-mm visual analog scale (VAS), and body mass index of 25 kg/m2 or higher were recruited and randomly assigned to receive oral metformin (2,000 mg/day) or identical placebo (54 and 53 participants, respectively) for six months.

The researchers found that the mean change in VAS pain was −31.3 and −18.9 mm in the metformin and placebo groups, respectively, at six months, corresponding to an effect size (standardized mean difference) of 0.43. Diarrhea and abdominal discomfort were the most common adverse events reported.

"These findings support a potential role of metformin in improving symptoms in individuals with knee OA and overweight or obesity," the authors write. "However, given the relatively small sample size, a confirmatory study is needed."

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