NCT04626089

Brief Summary

The purpose of this study is to evaluate the efficacy and safety of metformin glycinate at dose of 620 mg twice per day plus standard treatment comparing to standard treatment alone (we will use placebo) of patients who have metabolic syndrome or type 2 diabetes, which have severe acute respiratory syndrome secondary to SARS-CoV-2.

Trial Health

30
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Timeline
Completed

Started Feb 2021

Geographic Reach
1 country

1 active site

Status
withdrawn

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

October 23, 2020

Completed
20 days until next milestone

First Posted

Study publicly available on registry

November 12, 2020

Completed
3 months until next milestone

Study Start

First participant enrolled

February 1, 2021

Completed
Same day until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2021

Completed
Last Updated

April 8, 2021

Status Verified

November 1, 2020

Enrollment Period

Same day

First QC Date

October 23, 2020

Last Update Submit

April 5, 2021

Conditions

Keywords

SARS-CoV 2Metabolic SyndromeType 2 diabetesSevere Acute Respiratory SyndromeMetformin glycinate

Outcome Measures

Primary Outcomes (1)

  • Viral Load

    Assess differences in SARS-CoV-2 viral load between participants that receive placebo vs metformin glycinate

    Day 0 to Day 8 or patient discharge day

Secondary Outcomes (11)

  • Days of supplementary oxygen if apply

    Day 0 to day 28 or patient discharge day

  • Days of supplementary mechanical ventilation if apply

    Day 0 to day 28 or patient discharge day

  • Days of Hospitalization

    Day 0 to day 28 or patients discharge day

  • Normalization of fever

    Day 0 to day 28 or patient discharge day

  • Normalization of oxigen saturation

    Day 0 to day 28 or patient discharge day

  • +6 more secondary outcomes

Study Arms (2)

Metformin glycinate

EXPERIMENTAL

620 mg bid (PO) plus standard treatment for 14 days

Drug: metformin glycinate

Placebo

PLACEBO COMPARATOR

Placebo tablets bid (PO) plus standard treatment for 14 days

Drug: Placebo oral tablet

Interventions

Participants randomized to metformin glycinate wil take 620 mg bid (PO) plus standard treatment for 14 days

Also known as: DMMET
Metformin glycinate

Participants randomized to placebo will take a tablet bid (PO) plus standard treatment for 14 days

Also known as: Placebo
Placebo

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • ≥ 18 years old
  • Ability to understand and the willingness to sign a written informed consent document before any study procedure
  • Metabolic syndrome or type 2 diabetes
  • Coronavirus infection, severe acute respiratory syndrome SARS-CoV- 2 confirmed by the Polymerase Chain Reaction test (PCR) ≤ 4 days before of the randomization.
  • Hospitalized patient.
  • Radiographic evidence of pulmonary infiltrates

You may not qualify if:

  • Participation in any other clinical trial of an experimental treatment for COVID-19
  • Evidence of multi-organ failure
  • Require mechanical ventilation before randomization
  • Pregnant patients

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Hospital Juárez de México, OPD

Mexico City, 07760, Mexico

Location

Related Publications (48)

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    PMID: 18772132BACKGROUND
  • Glucophage Product Monograph (metformin hydrochloride) Sanofi-Aventis Canada. Rev.28th October 2008

    BACKGROUND
  • NDA 20-357, Glucophage. US Food and Drug Administration. Center for Drug Evaluation and Research. Freedom of Information Office. New Drug Approval Packages. Pharmacology/Toxicology Review.

    BACKGROUND
  • NDA 21-842, Actoplus met. US Food and Drug Administration. Center for Drug Evaluation and Research. Freedom of Information Office. New Drug Approval Packages. Pharmacology/Toxicology Review.

    BACKGROUND
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  • Hudson BG, Tryggvason K, Sundaramoorthy M, Neilson EG. Alport's syndrome, Goodpasture's syndrome, and type IV collagen. N Engl J Med. 2003 Jun 19;348(25):2543-56. doi: 10.1056/NEJMra022296. No abstract available.

  • Quinones S, Bernal D, Garcia-Sogo M, Elena SF, Saus J. Exon/intron structure of the human alpha 3(IV) gene encompassing the Goodpasture antigen (alpha 3(IV)NC1). Identification of a potentially antigenic region at the triple helix/NC1 domain junction. J Biol Chem. 1992 Oct 5;267(28):19780-4.

  • Revert F, Penades JR, Plana M, Bernal D, Johansson C, Itarte E, Cervera J, Wieslander J, Quinones S, Saus J. Phosphorylation of the Goodpasture antigen by type A protein kinases. J Biol Chem. 1995 Jun 2;270(22):13254-61. doi: 10.1074/jbc.270.22.13254.

  • Borza CM, Borza DB, Pedchenko V, Saleem MA, Mathieson PW, Sado Y, Hudson HM, Pozzi A, Saus J, Abrahamson DR, Zent R, Hudson BG. Human podocytes adhere to the KRGDS motif of the alpha3alpha4alpha5 collagen IV network. J Am Soc Nephrol. 2008 Apr;19(4):677-84. doi: 10.1681/ASN.2007070793. Epub 2008 Jan 30.

  • Raya A, Revert-Ros F, Martinez-Martinez P, Navarro S, Rosello E, Vieites B, Granero F, Forteza J, Saus J. Goodpasture antigen-binding protein, the kinase that phosphorylates the goodpasture antigen, is an alternatively spliced variant implicated in autoimmune pathogenesis. J Biol Chem. 2000 Dec 22;275(51):40392-9. doi: 10.1074/jbc.M002769200.

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  • Revert F, Merino R, Monteagudo C, Macias J, Peydro A, Alcacer J, Muniesa P, Marquina R, Blanco M, Iglesias M, Revert-Ros F, Merino J, Saus J. Increased Goodpasture antigen-binding protein expression induces type IV collagen disorganization and deposit of immunoglobulin A in glomerular basement membrane. Am J Pathol. 2007 Nov;171(5):1419-30. doi: 10.2353/ajpath.2007.070205. Epub 2007 Oct 4.

  • Revert-Ros F, Lopez-Pascual E, Granero-Molto F, Macias J, Breyer R, Zent R, Hudson BG, Saadeddin A, Revert F, Blasco R, Navarro C, Burks D, Saus J. Goodpasture antigen-binding protein (GPBP) directs myofibril formation: identification of intracellular downstream effector 130-kDa GPBP-interacting protein (GIP130). J Biol Chem. 2011 Oct 7;286(40):35030-43. doi: 10.1074/jbc.M111.249458. Epub 2011 Aug 9.

  • Darris C, Revert F, Revert-Ros F, Gozalbo-Rovira R, Feigley A, Fidler A, Lopez-Pascual E, Saus J, Hudson BG. Unicellular ancestry and mechanisms of diversification of Goodpasture antigen-binding protein. J Biol Chem. 2019 Jan 18;294(3):759-769. doi: 10.1074/jbc.RA118.006225. Epub 2018 Oct 30.

  • Revert F, Revert-Ros F, Blasco R, Artigot A, Lopez-Pascual E, Gozalbo-Rovira R, Ventura I, Gutierrez-Carbonell E, Roda N, Ruiz-Sanchis D, Forteza J, Alcacer J, Perez-Sastre A, Diaz A, Perez-Paya E, Sanz-Cervera JF, Saus J. Selective targeting of collagen IV in the cancer cell microenvironment reduces tumor burden. Oncotarget. 2018 Jan 19;9(13):11020-11045. doi: 10.18632/oncotarget.24280. eCollection 2018 Feb 16.

  • Swanton C, Marani M, Pardo O, Warne PH, Kelly G, Sahai E, Elustondo F, Chang J, Temple J, Ahmed AA, Brenton JD, Downward J, Nicke B. Regulators of mitotic arrest and ceramide metabolism are determinants of sensitivity to paclitaxel and other chemotherapeutic drugs. Cancer Cell. 2007 Jun;11(6):498-512. doi: 10.1016/j.ccr.2007.04.011.

  • Szegezdi E, Logue SE, Gorman AM, Samali A. Mediators of endoplasmic reticulum stress-induced apoptosis. EMBO Rep. 2006 Sep;7(9):880-5. doi: 10.1038/sj.embor.7400779.

  • Fung TS, Liu DX. Human Coronavirus: Host-Pathogen Interaction. Annu Rev Microbiol. 2019 Sep 8;73:529-557. doi: 10.1146/annurev-micro-020518-115759. Epub 2019 Jun 21.

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  • Schimmack G, Defronzo RA, Musi N. AMP-activated protein kinase: Role in metabolism and therapeutic implications. Diabetes Obes Metab. 2006 Nov;8(6):591-602. doi: 10.1111/j.1463-1326.2005.00561.x.

  • Sriwijitkamol A, Musi N. Advances in the development of AMPK-activating compounds. Expert Opin Drug Discov. 2008 Oct;3(10):1167-76. doi: 10.1517/17460441.3.10.1167.

  • Musi N, Hirshman MF, Nygren J, Svanfeldt M, Bavenholm P, Rooyackers O, Zhou G, Williamson JM, Ljunqvist O, Efendic S, Moller DE, Thorell A, Goodyear LJ. Metformin increases AMP-activated protein kinase activity in skeletal muscle of subjects with type 2 diabetes. Diabetes. 2002 Jul;51(7):2074-81. doi: 10.2337/diabetes.51.7.2074.

  • Shaw RJ, Lamia KA, Vasquez D, Koo SH, Bardeesy N, Depinho RA, Montminy M, Cantley LC. The kinase LKB1 mediates glucose homeostasis in liver and therapeutic effects of metformin. Science. 2005 Dec 9;310(5754):1642-6. doi: 10.1126/science.1120781. Epub 2005 Nov 24.

  • Detaille D, Guigas B, Leverve X, Wiernsperger N, Devos P. Obligatory role of membrane events in the regulatory effect of metformin on the respiratory chain function. Biochem Pharmacol. 2002 Apr 1;63(7):1259-72. doi: 10.1016/s0006-2952(02)00858-4.

  • Stumvoll M, Nurjhan N, Perriello G, Dailey G, Gerich JE. Metabolic effects of metformin in non-insulin-dependent diabetes mellitus. N Engl J Med. 1995 Aug 31;333(9):550-4. doi: 10.1056/NEJM199508313330903.

  • Otto M, Breinholt J, Westergaard N. Metformin inhibits glycogen synthesis and gluconeogenesis in cultured rat hepatocytes. Diabetes Obes Metab. 2003 May;5(3):189-94. doi: 10.1046/j.1463-1326.2003.00263.x.

  • Fery F, Plat L, Balasse EO. Effects of metformin on the pathways of glucose utilization after oral glucose in non-insulin-dependent diabetes mellitus patients. Metabolism. 1997 Feb;46(2):227-33. doi: 10.1016/s0026-0495(97)90307-3.

  • Hother-Nielsen O, Schmitz O, Andersen PH, Beck-Nielsen H, Pedersen O. Metformin improves peripheral but not hepatic insulin action in obese patients with type II diabetes. Acta Endocrinol (Copenh). 1989 Mar;120(3):257-65. doi: 10.1530/acta.0.1200257.

  • Tamura Y, Watada H, Sato F, Kumashiro N, Sakurai Y, Hirose T, Tanaka Y, Kawamori R. Effects of metformin on peripheral insulin sensitivity and intracellular lipid contents in muscle and liver of overweight Japanese subjects. Diabetes Obes Metab. 2008 Sep;10(9):733-8. doi: 10.1111/j.1463-1326.2007.00801.x. Epub 2007 Oct 15.

  • Fischer M, Timper K, Radimerski T, Dembinski K, Frey DM, Zulewski H, Keller U, Muller B, Christ-Crain M, Grisouard J. Metformin induces glucose uptake in human preadipocyte-derived adipocytes from various fat depots. Diabetes Obes Metab. 2010 Apr;12(4):356-9. doi: 10.1111/j.1463-1326.2009.01169.x.

  • Cataldo NA, Abbasi F, McLaughlin TL, Basina M, Fechner PY, Giudice LC, Reaven GM. Metabolic and ovarian effects of rosiglitazone treatment for 12 weeks in insulin-resistant women with polycystic ovary syndrome. Hum Reprod. 2006 Jan;21(1):109-20. doi: 10.1093/humrep/dei289. Epub 2005 Sep 9.

  • Cuthbertson J, Patterson S, O'Harte FP, Bell PM. Investigation of the effect of oral metformin on dipeptidylpeptidase-4 (DPP-4) activity in Type 2 diabetes. Diabet Med. 2009 Jun;26(6):649-54. doi: 10.1111/j.1464-5491.2009.02748.x.

  • Standeven KF, Ariens RA, Whitaker P, Ashcroft AE, Weisel JW, Grant PJ. The effect of dimethylbiguanide on thrombin activity, FXIII activation, fibrin polymerization, and fibrin clot formation. Diabetes. 2002 Jan;51(1):189-97. doi: 10.2337/diabetes.51.1.189.

  • Nichols GA, Gomez-Caminero A. Weight changes following the initiation of new anti-hyperglycaemic therapies. Diabetes Obes Metab. 2007 Jan;9(1):96-102. doi: 10.1111/j.1463-1326.2006.00580.x.

  • Landman GW, Kleefstra N, van Hateren KJ, Groenier KH, Gans RO, Bilo HJ. Metformin associated with lower cancer mortality in type 2 diabetes: ZODIAC-16. Diabetes Care. 2010 Feb;33(2):322-6. doi: 10.2337/dc09-1380. Epub 2009 Nov 16.

  • Gonzalez-Ortiz M, Martinez-Abundis E, Robles-Cervantes JA, Ramos-Zavala MG, Barrera-Duran C, Gonzalez-Canudas J. Effect of metformin glycinate on glycated hemoglobin A1C concentration and insulin sensitivity in drug-naive adult patients with type 2 diabetes mellitus. Diabetes Technol Ther. 2012 Dec;14(12):1140-4. doi: 10.1089/dia.2012.0097. Epub 2012 Sep 13.

  • JORGE GONZÁLEZ-CANUDAS, COMET GROUP Diabetes Efficacy and Safety of Metformin Glycinate vs. Metformin Hydrochloride in Metabolic Control and Inflammatory Mediators in Type 2 Diabetes Mellitus Patients. Diabetes 2019 Jun; 68(Supplement 1):

    RESULT
  • Garza-Ocañas L, Tamez-de la O E, Iglesias-Chiesa J, Gonzalez Canudas J, Rivas-Ruiz R: Pharmacokinetics and gastrointestinal tolerability of DMMET 01 (glycinate of metformin): results of a prospective randomized trial in healthy volunteers [abstract]. Diabetes 2009;58(Suppl 1):A533.

    RESULT
  • Granero F, Revert F, Revert-Ros F, Lainez S, Martinez-Martinez P, Saus J. A human-specific TNF-responsive promoter for Goodpasture antigen-binding protein. FEBS J. 2005 Oct;272(20):5291-305. doi: 10.1111/j.1742-4658.2005.04925.x.

  • Foretz M, Hebrard S, Leclerc J, Zarrinpashneh E, Soty M, Mithieux G, Sakamoto K, Andreelli F, Viollet B. Metformin inhibits hepatic gluconeogenesis in mice independently of the LKB1/AMPK pathway via a decrease in hepatic energy state. J Clin Invest. 2010 Jul;120(7):2355-69. doi: 10.1172/JCI40671. Epub 2010 Jun 23.

  • Rada P, Mosquera A, Muntane J, Ferrandiz F, Rodriguez-Manas L, de Pablo F, Gonzalez-Canudas J, Valverde AM. Differential effects of metformin glycinate and hydrochloride in glucose production, AMPK phosphorylation and insulin sensitivity in hepatocytes from non-diabetic and diabetic mice. Food Chem Toxicol. 2019 Jan;123:470-480. doi: 10.1016/j.fct.2018.11.019. Epub 2018 Nov 9.

  • Choi YH, Lee MG. Effects of enzyme inducers and inhibitors on the pharmacokinetics of metformin in rats: involvement of CYP2C11, 2D1 and 3A1/2 for the metabolism of metformin. Br J Pharmacol. 2006 Oct;149(4):424-30. doi: 10.1038/sj.bjp.0706875. Epub 2006 Aug 29.

  • Dianben® 1000 mg polvo para solución oral. Ficha técnica del producto. Nº de autorización de comercialización: 70545. Merck Santé S.A.S. 37 rue Saint Romain. 69008 Lyon. Francia. Fecha de revision 2010. Consultada en la web de la Agencia Española del Medicamento y de Productos Sanitarios (www.aemps.gob.es) el 27 de Marzo del 2013

    RESULT
  • Giugliano D, De Rosa N, Di Maro G, Marfella R, Acampora R, Buoninconti R, D'Onofrio F. Metformin improves glucose, lipid metabolism, and reduces blood pressure in hypertensive, obese women. Diabetes Care. 1993 Oct;16(10):1387-90. doi: 10.2337/diacare.16.10.1387.

  • Landin K, Tengborn L, Smith U. Treating insulin resistance in hypertension with metformin reduces both blood pressure and metabolic risk factors. J Intern Med. 1991 Feb;229(2):181-7. doi: 10.1111/j.1365-2796.1991.tb00328.x.

  • Quaile MP, Melich DH, Jordan HL, Nold JB, Chism JP, Polli JW, Smith GA, Rhodes MC. Toxicity and toxicokinetics of metformin in rats. Toxicol Appl Pharmacol. 2010 Mar 15;243(3):340-7. doi: 10.1016/j.taap.2009.11.026. Epub 2010 Jan 13.

  • Santure M, Pitre M, Gaudreault N, Marette A, Nadeau A, Bachelard H. Effect of metformin on the vascular and glucose metabolic actions of insulin in hypertensive rats. Am J Physiol Gastrointest Liver Physiol. 2000 May;278(5):G682-92. doi: 10.1152/ajpgi.2000.278.5.G682.

  • Verma S, Bhanot S, McNeill JH. Antihypertensive effects of metformin in fructose-fed hyperinsulinemic, hypertensive rats. J Pharmacol Exp Ther. 1994 Dec;271(3):1334-7.

MeSH Terms

Conditions

Metabolic SyndromeDiabetes Mellitus, Type 2Severe Acute Respiratory Syndrome

Condition Hierarchy (Ancestors)

Insulin ResistanceHyperinsulinismGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesDiabetes MellitusEndocrine System DiseasesRespiratory Tract InfectionsInfectionsCoronavirus InfectionsCoronaviridae InfectionsNidovirales InfectionsRNA Virus InfectionsVirus DiseasesRespiratory Tract Diseases

Study Officials

  • Fausto González-Villagrán, MD

    Hospital Juárez de México, OPD

    PRINCIPAL INVESTIGATOR
0

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
Parallel assignment experimental and placebo tablets will have same physical appearance and medicine box will be identified by kit number
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Experimental group: Metformin glycinate 620 mg bid (PO) plus standard treatment for 14 days. Control Group: Placebo bid (PO) plus standard treatment for 14 days plus
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 23, 2020

First Posted

November 12, 2020

Study Start

February 1, 2021

Primary Completion

February 1, 2021

Study Completion

February 1, 2021

Last Updated

April 8, 2021

Record last verified: 2020-11

Data Sharing

IPD Sharing
Will not share

Locations