Metformin Use in Rheumatoid Arthritis

NCT ID: NCT03863405

Last Updated: 2019-05-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-01-09

Study Completion Date

2020-01-09

Brief Summary

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Metformin has been used clinically for over 50 years, as a glucose lowering agent.

Direct and indirect anti-inflammatory effects of metformin have been reported in animal and clinical studies, and this effect is independent of its hypoglycemic effect.

Animal studies showed that metformin decreased serum C-reactive protein (CRP) level in atherogenic rabbits and decreased proinflammatory cytokines (interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF-α) in obese mice .

Moreover, metformin also suppressed osteoclastogenesis ; this may partially result from decreased expression of inflammatory cytokines that promote osteoclastogenesis in the arthritic joint.

The objective of this study is to evaluate the efficacy and safety of addition of metformin to standard disease modifying anti-rheumatic drugs (DMARDs) in patients with rheumatoid arthritis.

Detailed Description

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Conditions

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Rheumatoid Arthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
single blinded

Study Groups

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Metformin Group

850 mg metformin twice daily for six months in addition to standard therapy

Group Type EXPERIMENTAL

Metformin

Intervention Type DRUG

metformin 850 mg bid for RA patients with moderate to high disease activity provided by DAS-28 score greater than 3.2

Conventional DMARDs

Intervention Type DRUG

methotrexate, leflunomide, hydroxychloroquine or sulfasalazine

Control Group

placebo in addition to standard therapy for rheumatoid arthritis

Group Type ACTIVE_COMPARATOR

Conventional DMARDs

Intervention Type DRUG

methotrexate, leflunomide, hydroxychloroquine or sulfasalazine

Placebo Oral Tablet

Intervention Type DRUG

oral tablet

Interventions

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Metformin

metformin 850 mg bid for RA patients with moderate to high disease activity provided by DAS-28 score greater than 3.2

Intervention Type DRUG

Conventional DMARDs

methotrexate, leflunomide, hydroxychloroquine or sulfasalazine

Intervention Type DRUG

Placebo Oral Tablet

oral tablet

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients older than 18 years (of both sexes) diagnosed with rheumatoid arthritis according to ACR / EULAR 2010 criteria .
* Patients with moderate to high disease activity (DAS - 28 . score greater than 3.2)
* Patients received the standard therapy (i.e. one or more conventional DMARDs) for at least three months.

Exclusion Criteria

* Known hypersensitivity to metformin.
* Patients who have a prior diagnosis with diabetes mellitus.
* Patients receive metformin for any other indications.
* Patients with congestive heart failure.
* Patients with a history of myocardial infarction.
* Patients with severe anemia.
* Patients with active infections or other inflammatory diseases.
* Patients receiving biological therapy.
* Pregnancy or lactation.
* Patients with impaired liver functions.
* Patients with impaired kidney functions (serum creatinine concentrations ≥1.5 and ≥1.4 mg/dL in males and females respectively).
* Patients with malignancies.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Future University in Egypt

OTHER

Sponsor Role collaborator

Ain Shams University

OTHER

Sponsor Role lead

Responsible Party

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Mahmoud Mustafa Mahmoud Gharib

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Al-Zahraa University Hospital

Cairo, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Walaa F EL-Baz

Role: CONTACT

01112108071

Facility Contacts

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Mahmoud M Gharib

Role: primary

Other Identifiers

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215

Identifier Type: -

Identifier Source: org_study_id

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