| Title: | Association of metformin with osteoarthritis progression and total joint arthroplasty: evidence from the UK Biobank, a large population-based cohort study |
| Journal: | Clinical Rheumatology |
| Published: | 29 Jun 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42371366/ |
| DOI: | https://doi.org/10.1007/s10067-026-08181-0 |
Publication 20686
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Abstract
ObjectiveTo assess the association between metformin and osteoarthritis (OA) development and total joint arthroplasty (TJA) in a large prospective cohort.MethodsFrom the UK Biobank, 348,070 people between the ages of 40 and 69 who did not have OA or TJA at baseline were included between 2006 and 2010 and investigated until January 2021. We used multivariable-adjusted Cox regression to test for an association between metformin and OA diagnosis (n = 51,111) and OA-related TJA (n = 21,754) in the cohort. Models 1 and 2 were adjusted for age, sex, and diabetes. Model 2 was also adjusted for additional variables, including the Townsend Deprivation Index, ethnicity, household income, body mass index, glycated hemoglobin, smoking and alcohol status, physical activity, hypertension, and medications including antihypertensive drug use, statin use, insulin treatment, aspirin use and glucosamine/chondroitin supplementation.ResultsAt baseline, 14,128 (4.06%) of the 348,070 participants reported metformin prescriptions. The hazard ratio (HR) for OA, including knee OA (HR, 0.74; 95% confidence intervals (CI), 0.69 to 0.80) and hip OA (HR, 0.74; 95% CI 0.67 to 0.82), was 0.74 (95% CI, 0.70 to 0.77) for metformin users versus nonusers, but not hand OA (HR, 0.91; 95% CI 0.68 to 1.21). Metformin also reduced the risk of TJA (HR, 0.72; 95% CI 0.67 to 0.78). For OA, the association seemed to be stronger among nonobese, nondiabetic, and nonhypertensive participants (all p < 0.05).ConclusionsMetformin seems to reduce the risk of OA and TJA and may protect against OA in the general population.Key Points• Metformin use was associated with a reduced risk of overall OA, specifically knee OA and hip OA, but no significant association was observed with hand OA.• Metformin also reduced the risk of OA-related TJA, and the protective association with OA was stronger in male, nonobese, nondiabetic, and nonhypertensive participants.• The findings provide evidence that metformin may have a protective effect against OA development and OA-related TJA in the general population, offering new insights into potential strategies for OA prevention.</p>
15 Authors
- Yunze Kang
- Yiling Liu
- Lingli Long
- Weishen Chen
- Zhiqi Zhang
- Minghui Gu
- Chao Wang
- Chengxin Li
- Shiyong Zhang
- Baiqi Pan
- Xiaoyu Wu
- Ali Mobasheri
- Ziji Zhang
- Puyi Sheng
- Linli Zheng
1 Application
| Application ID | Title |
|---|---|
| 71986 | The potential therapeutic effects of metformin in osteoarthritis |
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