Results from a placebo-controlled study of metformin showed that this drug clearly helped insulin resistance and decreased weight and blood pressure in HIV positive subjects experiencing lipodystrophy.
After the initial three-month placebo-controlled part of the study, researchers offered subjects on placebo the option of receiving metformin. Those subjects who had received metformin from the start of the study could continue to do so provided that they had obtained benefit from the drug during the initial three-month phase.
A total of 19 subjects (2 female, 17 male) decided to enter this extension of the original three- month study. Their profile was as follows:
The dose of metformin used was 500 mg twice daily.
Researchers monitored subjects for a total of nine months. During the initial three-month part of the study, insulin levels fell significantly only among those subjects who received metformin. This decrease was maintained for the rest of the study. In those subjects who initially received placebo, insulin levels fell significantly only after they received metformin in the second part of the study.
Those subjects who received metformin for a total of nine months had the greatest loss of excess weight, particularly of fat around the waist, compared to subjects who received the drug for only six months.
According to the researchers, mild diarrhea occurred in 75% of subjects who received metformin but this problem cleared between three and six months after they started using the drug. No serious side effects were reported. Nor did anyone develop lactic acidosis — a side effect of metformin therapy.
REFERENCES
1. Hadigan C, Corcoran C, Basgoz N, et al. Metformin in the treatment of HIV lipodystrophy syndrome: a randomized controlled trial. Journal of the American Medical Association 2000;284:472-477.
2. Hadigan C, Rabe J, Davis B, et al. Sustained benefits of metformin therapy in HIV lipodystrophy. Abstract 69 - 3rd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, 23-26 October 2001, Athens, Greece.
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