ABSTRACT:
Metformin repositioning is a hot interesting topic and valuable substitute to molecular target based drug discovery as therapeutic switching using off-target strategy. It is a relatively inexpensive pathway due to availability of previous pharmacological and safety data. The author performed a Scopus database literature review of articles published on repositioning of metformin with special consideration of all details published on 2016, 2017 and 2018 as the latest updated literature that described concisely metformin as a potential pleiotropic multi-therapeutic agent. The repositioning of already a marketed anti-diabetic drug saves the high cost of the time-consuming normal drug development process for the other mentioned pharmacological activities. Metformin inhibits dyskinesia in Parkinson’s disease, cancer recurrence, neuroendocrine tumors, colorectal carcinoma, prostate cancer, breast cancer, pancreatic cancer, cholangiocarcinoma, fibrosarcoma and even enhancing the healing process for liver injury, cardiovascular disease and Fragile X syndrome. Metformin is beneficial for neurodegenerative diseases especially Alzheimer disease. And it up regulates neurotrophic factor and prevents dopaminergic neuron death in Parkinson’s model. As one of the most frequently used oral anti-diabetic drugs, it also improves serum lipid profiles, positively influences hemostasis, cognitive impairment and possesses anti-inflammatory properties. Results of several clinical studies confirm that long term use of metformin in diabetic patients contributes to better cognitive function, compared to participants using other anti-diabetic drugs. This supports the position of metformin as first-line therapy and implies that metformin may confer benefit in non-diabetics.