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NCT Number: NCT06999343

Exploring the Anti-ageing Effects of Metformin in COPD

Prospective, multicentre, double-blind, placebo-controlled, randomised, prospective clinical trial comparing the effect of metformin 850 mg twice daily with placebo in COPD patients with evidence of emphysema (by CT scan or reduced DLCO) who are known to have a rapid decrease in FEV1.

Main objective:

To compare the change in FEV1 at 3 years follow-up in patients receiving metformin versus placebo.

Participants will take metformin (850mg) or placebo twice daily for 3 years.

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Key information

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Sign the informed consent form prior to any study-specific procedure.
  • Male or female, aged 40 to 75 years, inclusive, at the time of Screening.
  • Have a COPD clinic diagnostic according to Global Initiative for Obstructive Lung Disease (GOLD) 2022 with a post-bronchodilator FEV1/FVC <0.7 at Screening (Visit 1)
  • Have a post-bronchodilator FEV1 >40% ≤ 70% of the predicted value at Screening (Visit 1)
  • Smoking history of more than 10 pack/years ([number of cigarettes smoked per day x number of years smoked]/20)
  • Must have been able to understand and comply with the requirements of the study, as judged by the investigator.
  • Have some kind of emphysema (centrolobulillar or paraseptal) reported by an expert radiologist.
  • Have a certified decrease of the Lung Function in the last 3 years >40 ml/ml per year of FEV1.
  • Women in childbearing age with negative pregnancy test.

Exclusion criteria

  • Participating in another clinic trial with any commercially or investigational biological medicinal product within 4 months prior to Screening.
  • Patients who take oral corticosteroids chronically.
  • Respiratory track infection history (superior respiratory tract included) and pulmonary exarcerbation within 6 weeks prior to Screening.
  • Lung resection or lung volume reduction surgery within 12 months prior to Screening (Visit 1), or lung trasplant history, or, as judged by the investigator, patient may have required a thoracotomy or other lung surgery during the study.
  • Known active tuberculosis.
  • History of intersticial lung or massive pulmonary thromboembolic disease.
  • History of bronchiectasis secondary to respiratory diseasesother than COPD (e.g. cystic fibrosis, Kartagener's syndrome, etc.).
  • Any clinically significant disease or disorder (e.g. cardiovascular, gastrointestinal, hepatic, renal (GFR < 30 ml/min), neurological, musculoskeletal, endocrine, metabolic, psychiatric, and major physical impairment) that, in the opinion of the investigator, could have placed the patient at risk for participation in the study, could have influenced the study results, or could have affected the patient's ability to participate in the study.
  • Recent history (within 12 months prior to screening [Visit 1]) of myocardial infarction, recent history of heart failure (New York Heart Association [NYHA] classes III and IV), pulmonary oedema and/or cardiac arrhythmia.
  • History of cancer (within 5 years prior to Visit 1), except non-metastatic skin cancer and non-melanoma.
  • Patients who cannot perform spirometry manoeuvres or tolerate plethysmography.
  • Contraindications to the use of metformin: allergy to the drug, advanced renal failure (CKD stage 3 and above), patients on dialysis, chronic metabolic or respiratory acidosis or liver cirrhosis.
  • Patients with type 2 Diabetes Mellitus with or without previous use of metformin.
  • Pregnant women, nursing mothers or women of childbearing age who are not going to use contraceptive methods.

Treatment and study plan

Metformin 850Mg Tab

Drug

Tolerance phase dose: 850mg/24h for 2 weeks. Treatment dose: 1700 mg twice daily.

Placebo

Other

Tolerance phase dose: One tablet/24h for 2 weeks. Treatment dose: Two tablets twice daily.

Primary outcomes

  1. Forced expiratory volume in the first second (FEV1)

    Time frame: At inclusion and at 3-years follow-up

    The amount of air expelled during the first second of a maximal expiration, performed after a maximal inspiration.

  2. Carbon monoxide diffusion test (DLCO)

    Time frame: At inclusion and at 3-years follow-up

    Pulmonary function test, in which the diffusion of gases through the pulmonary alveoli into the blood is studied.

Secondary outcomes

  1. Age

    Time frame: Baseline

    Years

  2. Sex at birth

    Time frame: Baseline

    Male/Female

  3. Height

    Time frame: Baseline

    Centimetres

  4. Weight

    Time frame: Baseline and at 1 year, 2 years and 3 years

    Kg

  5. Smoking

    Time frame: Baseline

    Cigarette packs/year

  6. The percentage of lung volume with emphysema measured on a chest CT scan.

    Time frame: At inclusion and at 3-years follow-up

  7. 6-minute walk distance (6MWT)

    Time frame: Baseline and at 1 year, 2 years and 3 years

    Metres in 6 minutes

  8. Grip strength with dynamometer

    Time frame: Baseline and at 1 year, 2 years and 3 years

    Kg

  9. BODE Index

    Time frame: Baseline and month 6, 12, 18, 24, 30 and 36

    The BODE index will result in a score of zero to ten dependent upon FEV1, body-mass index, the distance walked in six minutes, and the modified MRC dyspnea scale where 0 is the best state of health and 10 is the worst.

  10. Dyspnoea

    Time frame: Baseline and at 1 year, 2 years and 3 years

    1, 2, 3, 4 or 5 grades where dyspnoea grade 1 is the best state of health and grade 5 is the worst state of health

  11. Major cardiovascular events

    Time frame: Month 6, 12, 18, 24, 30 and 36

    Select from a list (Myocardial infarction/new angina/stroke) if any of these events happen.

  12. Cancer events

    Time frame: Month 6, 12, 18, 24, 30 and 36

    Solid cancers Yes/No

  13. Renal dysfunction (microalbuminuria)

    Time frame: Month 6, 12, 18, 24, 30 and 36

    mg/g

  14. Concomitant treatment

    Time frame: Month 6, 12, 18, 24, 30 and 36

    EPOC concomitant treatment

  15. Exacerbations

    Time frame: Month 6, 12, 18, 24, 30 and 36

    YES/NO

  16. Emergency room visits

    Time frame: Month 6, 12, 18, 24, 30 and 36

    YES/NO

  17. Hospitalisations

    Time frame: Month 6, 12, 18, 24, 30 and 36

    YES/NO

  18. Intubation

    Time frame: Month 6, 12, 18, 24, 30 and 36

    YES/NO

  19. Obstruction

    Time frame: Month 6, 12, 18, 24, 30 and 36

    YES/NO

Study contacts

Contact information is provided by the study sponsor or research team.

Alberto Labiano Tabar

CONTACT

[email protected]

+34 848 42 32 36

Sponsors and collaborators

Lead sponsor

Fundación Instituto de Investigación Sanitaria de Navarra

Other

Registry information

Acronym: AMICO

Important dates

Study start
2025
Primary completion
2029
Study completion
2029
First posted
May 31, 2025
Registry last updated
May 31, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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