I have started taking Metformin---my family physician is a big fan of this drug. He feels that it is a medication with alot of benefits. ...even against Covid- "Metformin is a widely available anti-diabetic agent that has an excellent safety profile, and clinical and preclinical data suggest metformin may offer cardiopulmonary protection in COVID-19 via enhanced ACE2 expression." (30 articles about this on pubmed). With the regular Metformin-I suffered from abdominal pain and diarrhoea. I read further, and now take an extended release form. NO more GI - issues.
I have not spoken to my neurosurgeon about this.....
Association of Metformin With the Growth of Vestibular Schwannomas.
Tran S, Killeen DE, Qazi S, Balachandra S, Hunter JB.
Otolaryngol Head Neck Surg. 2020 Jul 7:194599820937970. doi: 10.1177/0194599820937970. Online ahead of print.
Objective: To assess whether medication use, specifically statin, metformin, and aspirin, affects the growth of vestibular schwannomas (VSs).
Study design: Retrospective case series.
Setting: Single tertiary care academic hospital.
Subjects and methods: Patients were enrolled if they were diagnosed with sporadic VS and had at least 2 magnetic resonance imaging (MRI) studies at a minimum of 6 months apart prior to any intervention. Electronic medical records were reviewed for demographic and medication data. Tumor volumes on MRI studies were assessed via BrainLab iPlan. The primary endpoint was VS tumor growth, defined as a 20% increase in tumor volume, between consecutive MRI studies or between the first and last available MRI study. Predictors of volumetric growth, specifically statin, aspirin, or metformin use, were analyzed with t tests, chi-square test, univariate logistic regression, and multivariate logistic regression.
Results: A total of 387 patients met inclusion criteria, 53.5% of whom were women. For all patients, the mean age was 60.6 years (range, 18.2-89.2 years); the mean axial tumor diameter, 11.9 mm (range, 1.7-32.0 mm); and the mean tumor volume, 0.85 cm3 (range, 0.01-13.1 cm3). In review of the electronic medical record, 46 patients (11.9%) were taking metformin; 145 (37.5%), a statin; and 117 (30.2%), aspirin. Among patients taking metformin, 39.1% (18/46) exhibited volumetric growth, as opposed to 58.2% (198/340) of nonusers (P = .014). Metformin (odds ratio, 0.497; P = .036) is significantly associated with reduced VS growth when controlling for aspirin, statin, and tumor size on multivariate logistic regression.
Conclusion: Metformin use is associated with reduced volumetric VS growth.
Metformin Potential Impact on the Growth of Vestibular Schwannomas.
Feng AY, Enriquez-Marulanda A, Kouhi A, Ali NE, Moore JM, Vaisbuch Y.
Otol Neurotol. 2020 Mar;41(3):403-410. doi: 10.1097/MAO.0000000000002545.
Objective: Previous work has suggested that metformin may possess antineoplastic properties. This study aims to assess the effect of metformin on the growth of sporadic vestibular schwannomas.
Methods: A retrospective cohort study was performed on patients presenting with radiologically confirmed vestibular schwannomas to Stanford medical center between January 1990 and October 2018. Patients who received metformin during the follow-up period were included and were compared with the control group who were not receiving metformin. Tumor progression and hearing loss are primary and secondary outcomes, respectively.
Results: A total of 149 patients were analyzed, with 42 patients receiving metformin. The mean age at presentation is 69.6 (±11.7) years. There are 69 (46.3%) females and 80 (53.7%) males and there is no significant age difference between the groups. Tumor size at presentation is similar between both groups, 8 mm (4-13) in control group and 7.5 mm (4-14) in metformin group. The average follow-up period is 34.2 months (18.3-57.
and 30.3 months (13.6-69.
in the metformin and control cohorts, respectively, and they are not significantly different. No significant differences between both groups were found in final American Academy of Otolaryngology - Head and Neck Surgery hearing outcome or poor audiogram outcome. Metformin users are significantly less likely to present with tumor growth at final follow-up compared with nonmetformin users (28.6 versus 49.5%, respectively; p = 0.02).
Conclusions: This preliminary result suggests metformin may reduce vestibular schwannoma tumor growth rate and shows potential promise as a novel chemotherapeutic agent. Further studies are needed to validate this finding.