Metformin – the old drug with new therapeutic possibilities

Original Article, Pol J Public Health, Vol. 134 (2024): 47-51 Paulina Oleksa, Kacper Jasiński, Daria Żuraw, Mateusz Sobczyk, Monika Żybowska, Anna Rzewuska-Fijałkowska, Karolina Haczkur-Pawłowska, Piotr Więsyk Students’ Scientific Society at the Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, Poland Introduction. Metformin is an oral antidiabetic drug from the biguanide group, popularly referred as an aspirin of the 21st century. The therapeutic targets of metformin are expanding. It is characterized by antineoplastic, immunoregulatory, anti-aging and neuroprotective properties. We aimed to evaluate the pleiotropic effects of metformin, taking into account its different mechanisms, efficacy and safety in contemporary public health challenges. Material and methods. We conducted the literature review from 2014 to 2024 using the PubMed and Google Scholar. Results. Metformin, depending on the cancer and its stage, enhances the cancer treatment effects, prevents the drug resistance, lengthens overall time of survival, reduces the risk of recurrence. In the Parkinson’s disease, Alzheimer’s disease and depression metformin can even increase the risk of their occurrence, especially in high doses. Such doses predispose to the cobalamin deficiency, affecting the functioning of the nervous system. Metformin was effective in seizure control of epilepsy. It has positive impact on the course of some autoimmunological diseases. Among diabetics treatment, outcomes of COVID-19 and tuberculosis could be improved by metformin. Conclusions. Metformin is pluripotential drug. Possibilities of adjuvant metformin therapy are very promising, but it cannot be recommended as standard treatment. This issue requires further investigation, preferentially randomized controlled trials on the bigger research samples. Keywords: metformin and therapy, metformin and treatment, metformin and advances.