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Metformin + tofacitinib is a combination of two small molecule drugs with distinct mechanisms of action. Metformin is an oral antihyperglycemic agent primarily used for the management of type 2 diabetes mellitus; it acts mainly by activating adenosine monophosphate-activated protein kinase (AMPK), which decreases hepatic glucose production and improves insulin sensitivity. Tofacitinib is an oral Janus kinase (JAK) inhibitor developed for the treatment of autoimmune diseases such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and ulcerative colitis. It works by inhibiting JAK enzymes involved in cytokine signaling via the JAK-STAT pathway, thereby reducing inflammation and immune cell activation[5][6]. The combination has been studied preclinically for potential anti-inflammatory and anti-fibrotic effects in models such as systemic sclerosis[6].
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