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Metformin may prevent, treat preeclampsia

In vitro and ex vivo experiments revealed that metformin decreases levels of toxins that are elevated in women with preeclampsia and also repairs blood vessels, according to data published in the American Journal of Obstetrics and Gynecology.

This indicates that metformin, a drug commonly used in the treatment of type 2 diabetes and designated as safe for use in pregnant women, may be effective in the treatment and prevention of preeclampsia, Fiona C. Brownfoot, MBBS, Translational Obstetrics Group, University of Melbourne, Australia, and colleagues wrote.

“Metformin appears to be the aspirin of the 21st century, because the drug has been discovered to have unexpected health benefits not only in diabetes, but also in polycystic ovarian disease and recent work has highlighted its anti-cancer properties,” Roberto Romero, MD, DMedSci, the editor-in-chief for obstetrics of the American Journal of Obstetrics and Gynecology, said in a release.

"Preeclampsia is a serious pregnancy complication globally responsible for over 100 maternal and 400 perinatal deaths a day," Brownfoot and colleagues wrote. "An important step in the pathophysiology of this condition may be placental ischemia/hypoxia, which leads to the release of soluble fms-like tyrosine kinase 1 (sFlt-1) and soluble endoglin (sENG) into maternal circulation.

The researchers performed assays on several types of placental tissues from women with severe preeclampsia and gestationally matched controls. Results showed that metformin decreased sFlt-1 and sENG secretion, endothelial dysfunction and angiogenic sprouting and induced vasodilation.

"By using assays to replicate the endothelial and vascular dysfunction that may be occurring in preeclampsia, we found metformin reduces endothelial dysfunction, improves vasodilation and is angiogenic," Brownfoot and colleagues concluded. "Collectively, our results suggest metformin has potential to prevent or treat preeclampsia."

The researchers also stated that their findings justify a clinical trial that can assess the role of metformin in preeclampsia. – by Chelsea Frajerman Pardes

Disclosures: The authors report no relevant financial disclosures.