METFORMIN AS AN ADJUNCT THERAPY IN RHEUMATOID ARTHRITIS

Background: Rheumatoid arthritis (RA) is a chronic autoimmune condition leading to joint damage and systemic complications. While conventional DMARDs remain the cornerstone of treatment, there is growing interest in repurposing drugs like metformin for their antiinammatory and immunomodulatory effects. Objective: This study evaluates the efcacy of metformin as an add-on therapy in patients with RA already on conventional treatment, assessed via DAS-28 score, ESR, and CRP. Methods: This was a randomized, placebo-controlled, singleblinded study conducted at Government Kilpauk Medical College, Chennai. Sixty-four patients diagnosed with RAwere randomly assigned to two groups: standard treatment with placebo and standard treatment with metformin (250 mg BID) for 6 months. The primary outcome was improvement in DAS-28. Secondary outcomes included changes in tender/swollen joint counts, ESR, and CRP levels. Results: Patients receiving metformin showed a signicant reduction in DAS-28 scores (from 5.48 ± 0.62 to 3.18 ± 0.45, p<0.0001). Reductions were also observed in tender joint count (3.81 ± 1.33 to 0.28 ± 0.46), swollen joint count (5.38 ± 1.72 to 0.75 ± 0.62), ESR (32.75 ± 8.99 to 13.63 ± 4.58), and CRP(6.52 ± 2.15 to 2.48 ± 1.41), all with statistical signicance (p<0.0001). No serious adverse events were reported.Conclusion: Metformin demonstrated signicant anti-inammatory effects when used as an adjunct therapy in RA, reducing disease activity and inammatory markers. Its established safety prole and additional metabolic benets make it a promising candidate in RAmanagement.