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Updated: Jan 11, 2026
Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
Published on: September 20, 2024
Drug Repurposing for Reducing the Size of Benign Thyroid Nodules: A Systematic Review
Cristian Soto Jacome1,2,3,4, Andrea Arce-Camposano5, David Toro-Tobon1,2,3
1Care and AI Laboratory, Mayo Clinic, Rochester, MN 55902, USA.
Context:
Benign thyroid nodules (BTNs) are highly prevalent, and current treatment options are primarily invasive. There is a need for effective, noninvasive alternatives.
Objective:
To systematically evaluate the efficacy of repurposed pharmacologic agents in reducing the size of BTNs.
Data Sources:
MEDLINE, EMBASE, Cochrane databases, and Scopus were searched from inception to December 18, 2024.
Study Selection:
We included preclinical and clinical studies evaluating repurposed drugs for BTNs in adults. Of 1499 records screened, 20 studies met inclusion criteria: 6 randomized controlled trials (RCTs), 6 prospective cohorts, 3 retrospective observational studies, 3 case reports, 1 cross-sectional study, and 1 preclinical study.
Data Extraction:
Data were extracted independently in duplicate using a standardized form.
Data Synthesis:
Narrative synthesis was conducted due to heterogeneity. Metformin was the most frequently evaluated agent (7 studies), with 5 studies (including 2 RCTs) reporting statistically significant reductions in dominant nodule volume. One prospective study demonstrated a reduction in the maximum nodule diameter, which was not statistically significant, and 1 RCT showed no changes in nodule size after intervention. Statins (4 studies) and somatostatin analogues (4 studies) showed mixed results. Myo-inositol with selenium, herbal formulations, and immune checkpoint inhibitors showed promise in single studies or case reports.
Conclusion:
Metformin shows the most consistent potential for noninvasive reduction of BTN size, particularly in patients with metabolic comorbidities. However, current evidence is limited and heterogeneous. Further large-scale studies are needed to confirm efficacy and guide clinical use.
