Metformin and Weight Changes in Non-diabetic Older People With HIV (METFORAGING): A Double-Blind, Randomized, Placebo-Controlled, Pilot Trial
Abstract
Background: Weight gain is a major complication of contemporary antiretroviral treatment (ART). We evaluated the effects of metformin on weight trajectories and metabolic outcomes in non-diabetic, non-obese, older persons with HIV-1 (PWH).
Methods: In this double-blind, randomized, placebo-controlled pilot trial (METFORAGING), PWH 50 years or older, virologically suppressed, without diabetes or insulin resistance, were randomly assigned (1:1) to metformin 850 mg or placebo twice daily for 96 weeks at La Paz University Hospital (Madrid, Spain). This prespecified secondary analysis evaluated changes in body weight, body mass index (BMI), glycemic indices, lipid parameters, and serum growth differentiation factor-15 (GDF-15) in the per-protocol population.
Results: Forty participants were randomly assigned (metformin n = 19; placebo n = 21); 35 completed treatment through week 96 (per-protocol population). At week 96, mean weight change was -1.5 kg (95% CI -2.9 to -0.03) with metformin and +1.3 kg (-0.7 to 3.3) with placebo (between-group difference -2.8 kg [95% CI -5.2 to -0.4]; P = .025). After discontinuation, weight in the metformin group returned toward baseline (between-group difference from week 96 to 144: 2.2 kg [95% CI 0.05 to 4.5]; P = .045). At week 96, changes in body weight correlated inversely with changes in serum GDF-15 in the metformin group (r = -0.67; P = .003). No serious adverse events were attributed to metformin.
Conclusions: Metformin attenuated weight…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 21 participants or records.
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