Could metformin be used as a treatment for preeclampsia: A pilot study

Objective To test the effect of metformin on serum level of antiangiogenic factors, soluble endoglin (sEng) and soluble fms‑like tyrosine kinase‑1 (sFLT‑1), in patients with preeclampsia (PE). Patients and methods A controlled before and after prospective study was conducted on 40 patients with nonsevere PE conducted in a tertiary hospital setting. At admission, clinical and laboratory investigations had been done. Metformin tablets (500 mg three times daily) with meals were given from the time of study admission till delivery or termination of pregnancy. Serum level of sEng and sFLT‑1 were measured before and 1 week after metformin treatment. Outcome of delivery had been obtained. Results One week after metformin treatment, there was a statistically significant reduction in maternal sEng and sFLT‑1, with a mean difference of −448.86 ± 238.48 and −397.72 ± 125.52 pg/ml, respectively. In addition, there were significant reductions in both systolic blood pressure from 147 ± 12.4 to 131 ± 10.6 mmHg and diastolic blood pressure from 92 ± 7 to 85 ± 8.2 mmHg 1 week after metformin use. Five (12.5%) cases progressed to severe PE. Conclusion Metformin use for 1 week reduces the antiangiogenic biomarkers sEng and sFLT‑1, and it could have a role in the treatment of PE.