TEsting METformin Against Cognitive Decline in HD

NCT04826692 | Completed Phase 3

• 1 other identifier: TEMET-HD
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 9

Brief Summary

Multicenter, randomized, double-blind, placebo-controlled, parallel group study to assess the efficacy and safety of metformin treatment at a dose of 1700 mg / day in adults with Huntington's disease. The study consists of a screening period (2 to 4 weeks), followed by a 52-week double-blind treatment period and a follow-up visit (one month after the end of treatment).

Conditions

Huntington Disease

Keywords

Huntington disease; Metformin; AMPK; Huntingtina

Outcome Measures

Primary Outcomes (3)

• Evaluate the effect of metformin on the scores obtained in different cognitive subtests that make up the Unified Huntington's Disease Rating Scale

  The tests that make up this subscale are the Symbol Digit Modalities Test. It is a comparative test that is collected throughout the entire trial to assess the progression of cognitive functions in patients. The test has 90 seconds time limit.

  Baseline - Week 52

• Evaluate the effect of metformin on the scores obtained in different cognitive subtests that make up the Unified Huntington's Disease Rating Scale (UHDRS).

  The tests that make up this subscale are the verbal fluency under phonetic slogan with the letters F, A and S, It is a comparative test that is collected throughout the entire trial to assess the progression of cognitive functions in patients. It consists of four categories of time 0-15; 16-30; 31-45 and 46-60 seconds and both hits and errors are counted.

  Baseline - Week 52

• Evaluate the effect of metformin on the scores obtained in different cognitive subtests that make up the Unified Huntington's Disease Rating Scale (UHDRS).

  The tests that make up this subscale are words and interference in the Stroop test. The Stroop test was performed to determine selective attention and inhibitory response (selective response to stimuli) to recognize a different stimulus among others. The test involves three kinds of stimuli: three columns of color names printed in black (condition A), three columns with different colors (red, green, blue or black) (condition B), and three columns of color names printed in a color that does not necessarily correspond to the word (for For example, the word "green" printed in blue, (condition C). The 3 parts of the test consist of A. speed of reading the words (names of colors printed in black), B. speed of nomination, the subject must name the colors. C. inhibitory response, called the interference test, where the subject must name the color in which the word with the name of the other color. The test has 45 seconds time limit.

  Baseline - Week 52

Secondary Outcomes (7)

• Evaluate the effect of metformin on motor function in patients with Huntington's disease using the Unified Huntington's Disease Scale Total Motor Score.

  Baseline - Visit 1 (Week 0) - Week 26 - Week 52

• Evaluate the effect of metformin on functional capacity in patients with Huntington´s disease using Unified Huntington's Disease Scale Functional Capacity.

  Baseline - Visit 1 (Week 0) - Week 26 - Week 52

• Evaluate the effect of metformin on behavioral signs and symptoms in patients with Huntington´s disease using Problem Behaviors Assessment-Short form (PBA-s)

  Baseline - Visit 1 (Week 0) - Week 26 - Week 52

• Evaluate if there are genetic markers associated to metformin by analysis pharmacogenetic.

  Visit 1 (week 0)

• Analyze the light chain protein of neurofilaments in peripheral blood.

  Visit 1 (week 0) and Visit 8 (Week 56)

Study Arms (2)

Metformin

EXPERIMENTAL

Therapeutic group: Biguanidines (antidiabetic) Administration way: Oral Initial dose: 425 mg twice daily Maximum dose: 850 mg, twice daily Treatment duration: 12 months

Drug: Metformin

Placebo

PLACEBO COMPARATOR

Therapeutic group: NA Administration way: Oral Initial dose: 425 mg twice daily Maximum dose: 850 mg, twice daily Treatment duration: 12 months

Drug: Placebo

Interventions

Metformin DRUG

Metformin oral: 425 mg twice daily (initial dose) and 850 twice daily (maximum dose)

Also known as: Biguanides (oral antidiabetic)

Metformin

Placebo DRUG

425 mg twice daily (initial dose) and 850 twice daily (maximum dose)

Also known as: Not appicable

Placebo

Eligibility Criteria

• Age: 21 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Symptomatic positive clinical diagnosis of Huntington disease.
• Presence of 36 CAG repeats (or more) in the hunting gene based on centralized CAG analysis.
• Men or women between 21-65 years of age, inclusive, with an onset of HD at 18 years of age or older.
• Women of childbearing potential (women who are not postmenopausal children or who have not undergone surgical sterilization at times) will need to be using a contraceptive method for 30 days before beginning study treatment, and will have contact with at least two methods of birth control throughout the duration of the study and up to 30 days after taking the last dose of treatment.
• A sum of \> 4 points on the UHDRS-TMS scale and a diagnostic confidence level of 4.
• Scale of independence ≥ 75%.
• Score on the UHDRS-TFC scale ≥ 8 at the screening visit.
• They must be trained and willing to provide written informed consent prior to any procedure related to the study to be performed at the screening visit. Patients with a legal guardian must be determined according to local requirements.
• They must be trained and will require taking oral medication and will need to be determined to comply with the specific study procedures.
• They must be able to travel to the study center and, in the judgment of the investigator, demonstrate that it is probable that they can continue traveling during the study.
• Availability and willingness of a caregiver, informant, or family member to provide information during study visits that evaluate PBA-s. It is recommended that the caregiver be someone who cares for the patient at least 2 to 3 times a week and at least 3 hours per occasion. The suitability of the caregiver must be judged by the investigator.

You may not qualify if:

• The participant has taken metformin in the last three months before the start of the study.
• The participant has diabetes of any kind.
• The participant is pregnant or lactating.
• The participant has a medical condition other than HD (metabolism, kidney function, liver function, heart problems, etc.), or any contraindication against metformin.
• The participant has an uncontrolled psychiatric condition.
• Participant is allergic to metformin or any of the other ingredients of this medicine.
• The participant has kidney problems \[creatinine clearance \<60 ml / min calculated using Cockcroft-Gault formula\] or liver problems.
• The participant is dehydrated, from prolonged or severe diarrhea, or has vomited several times.
• The participant has a serious infection.
• The participant has been treated for heart failure or has recently had a heart attack, has severe circulation problems, or is having difficulty breathing.
• The participant drinks\> 6 units / day of alcohol (alcoholism).
• Participants diagnosed with oncological disease.
• Participants with a suicidal propensity, with an affirmative answer in items 4 or 5 in the C-SSRS at the screening visit.

Sponsors & Collaborators

• Instituto de Investigacion Sanitaria La Fe: lead

Study Sites (9)

Hospital General Universitario Dr. Balmis

Alicante, Alicante, 03010, Spain

Location

Hospital General Universitario de Elche

Elche, Alicante, 03203, Spain

Location

Hospital Universitari Son Espases

Palma de Mallorca, Balearic Islands, 07120, Spain

Location

Hospital Universitario Mare de Déu de la Mercé

Barcelona, Barcelona, 08035, Spain

Location

Hospital Universitario Burgos

Burgos, Castille and León, 09006, Spain

Location

Complejo Hospitalario de Albacete

Albacete, Castille-La Mancha, 02006, Spain

Location

Hospital Universitario Ramón y Cajal

Madrid, Madrid, 28034, Spain

Location

Hospital Universitario Central de Asturias

Oviedo, Principality of Asturias, 33011, Spain

Location

Hospital Universitario y Politécnico La Fe

Valencia, València, 46026, Spain

Location

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MeSH Terms

Conditions

Huntington Disease

Interventions

Metformin; Biguanides; Hypoglycemic Agents

Condition Hierarchy (Ancestors)

Basal Ganglia Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Dementia; Chorea; Dyskinesias; Movement Disorders; Heredodegenerative Disorders, Nervous System; Neurodegenerative Diseases; Genetic Diseases, Inborn; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Cognition Disorders; Neurocognitive Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Guanidines; Amidines; Organic Chemicals; Physiological Effects of Drugs; Pharmacologic Actions; Chemical Actions and Uses

Study Officials

• Carmen Peiró, Phd, MD

  Instituto de Investigación Sanitaria La Fe

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Masking Details: Double-blind
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 15, 2020
• First Posted: April 1, 2021
• Study Start: April 11, 2022
• Primary Completion: June 10, 2025
• Study Completion: June 10, 2025
• Last Updated: September 25, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

ES (9)