Nitazoxanide Reduces Oxidative Stress and Inflammation in Type 2 Diabetes Without Affecting Glycemic Control: Study

A new study published in the Endocrine journal showed that nitazoxanide lowers inflammation and oxidative stress without compromising glucose regulation in type 2 diabetes.

Hyperglycemia and anomalies in the metabolism of proteins, fats, and carbohydrates are hallmarks of diabetes mellitus (DM), a complicated metabolic disease. The majority of patients do not attain ideal glycemic control, even with the advancements in anti-diabetic medication therapy.

Using one-dimensional drug profile matching, nitazoxanide (NTZ), a broad-spectrum anti-infective medication that has efficacy against a variety of bacteria, viruses, helminthes, and protozoa, was determined to be an agonist of the peroxisome proliferative activated receptor gamma (PPARγ).

According to preclinical evidence, nitazoxanide (NTZ) may be a useful PPAR-γ agonist for type 2 diabetes. Therefore, this study was conducted by Eman Ghonaim and team with to investigate the tolerance and initial effects of NTZ as a supplement to the current metformin-vildagliptin combination on inflammatory biomarkers and glycemic control in individuals with type 2 diabetes.

In the control and NTZ groups, 88 patients (44 in each group) were examined. The combination of metformin and vildagliptin was used to treat every patient. Twice a day, 500 mg of nitazoxanide was administered orally to the NTZ group. Glycemic control, as measured by fasting blood glucose and glycated hemoglobin (HbA1c), was the main result. Fasting insulin, serum interleukin-6 (IL-6), asprosin, malondialdehyde (MDA), and high mobility group box 1 (HMGB-1) were examples of secondary outcomes. Every outcome was assessed both at baseline and three months later.

When comparing NTZ to control, a between-groups comparison showed substantially decreased levels of inflammatory markers [HMGB-1: 10.46 ng/mL (6.37–14.61) vs. 22.60 ng/mL (20.18–27.37) and IL-6: 23.64 ng/L (21.00–32.71) vs. 32.52 ng/L (29.63–36.13), P < 0.001 for both].

Insulin, asprosin, MDA, fasting blood glucose, and HbA1c did not significantly differ between the two groups. Following NTZ therapy, there were significantly decreased levels of IL-6 (P = 0.009), HMGB-1 (P < 0.001), asprosin (P = 0.002), and MDA (P < 0.001).

In contrast, the control group had a substantial rise in both HMGB-1 and IL-6 (P < 0.001 for both). There were no notable changes in any biomarkers between the two groups. Overall, despite no improvement in glycemic indices, nitazoxanide may reduce inflammation and oxidative stress in type 2 diabetes.

Source:

Ghonaim, E. M., Ibrahim, O. M., Hegazy, S. K., Farrag, W. F., & Badr, H. R. (2025). Repurposing nitazoxanide in type 2 diabetes mellitus: a randomized controlled trial. Endocrine. https://doi.org/10.1007/s12020-025-04387-5