Closing
Does metformin improve cardiovascular events versus placebo?
Mostly studied in type 2 & unspecified diabetes.
Not modeled yetTrial evidence exists, but no mechanistic model yetWithout a model there is no decisive experiment to propose. Help build it. →
Where the evidence stands
A coin flip. So far, the results disagree.
NoUnsureYes
- Belief
- 0.50 (range 0.00–0.55)
- Trials for
- 4
- Trials against
- 2
- Inconclusive
- 0
Already under way
- A Randomized, Open-label, Clinical Trial Evaluating the Anti-atherosclerotic Efficacy of Selected Antidiabetic Drugs in Patients With Coronary Artery Disease…NCT07254572 · recruiting · started 2025
- Evidence Based Evaluation of Incretin Drugs in Reducing the Risk of Cardiovascular and Cerebrovascular Events and Promoting the Remission of DiabetesNCT06959784 · enrolling by invitation · started 2024
- Improving the Diagnosis and Treatment of Cardiovascular Diseases in Kazakhstan by Introducing Correction of Metabolism With Glucagon-like Peptide 1 (GLP-1)…NCT07303556 · active not recruiting · started 2024
- CSP #2002 - Investigation of Metformin in Pre-Diabetes on Atherosclerotic Cardiovascular OuTcomes (VA-IMPACT)NCT02915198 · recruiting · started 2023
The evidence so far
- Registered trials
- 53
- With posted results
- 15
- Published papers
- 33
Of 6 decided analyses: 4 favor metformin, 2 find no difference, 0 favor the comparator.
Papers
- Effects of metformin versus glipizide on cardiovascular outcomes in patients with type 2 diabetes and coronary artery disease.Trial report · 2013
- Post-trial monitoring of a randomised controlled trial of intensive glycaemic control in type 2 diabetes extended from 10 years to 24 years (UKPDS 91).Trial report · 2024
- Protective effect of metformin on myocardial injury in metabolic syndrome patients following percutaneous coronary intervention.Trial report · 2014
- Comparative effect of saxagliptin and glimepiride with a composite endpoint of adequate glycaemic control without hypoglycaemia and without weight gain in patients uncontrolled with metformin therapy: Results from the SPECIFY study, a 48-week, multi-centre, randomized, controlled trial.Trial report · 2019
- Metformin and second- or third-generation sulphonylurea combination therapy for adults with type 2 diabetes mellitus.Meta-analysis / systematic review · 2019
- Reappraisal of metformin efficacy in the treatment of type 2 diabetes: a meta-analysis of randomised controlled trials.Meta-analysis / systematic review · 2012
Trials
- A Randomised Placebo Controlled Trial of the Effectiveness of Early MEtformin in Addition to Usual Care in the Reduction of Gestational Diabetes Mellitus Effects (EMERGE)NCT02980276 · 1 posted result
- Metformin Effect on Brain Function in Insulin Resistant Elderly PeopleNCT03733132 · 1 posted result
- A Randomized Phase 3 Trial of Metformin in Patients Initiating Androgen Deprivation Therapy as Prevention and Intervention of Metabolic Syndrome: The Prime StudyNCT03031821
- Comparison of Diabetes Retinopathy Among Type 2 Diabetic Patients Treated With Different Regimens: a Multicentre Randomized Parallel-group Clinical TrialNCT02587741
- The Effect of Adding Vildagliptin Versus Glimepiride to Metformin on Markers of Inflammation, Thrombosis, and Atherosclerosis in Diabetic Patients With Symptomatic Coronary Artery DiseasesNCT03693560
- Effects on Re-endothelialisation With Bydureon Treatment Add on to Insulin Versus Insulin Alone, Both in Combination With Metformin in Type 2 Diabetic SubjectsNCT02621489
- A Long Term, Open Label, Randomised Study in Patients With Type 2 Diabetes, Comparing the Combination of Rosiglitazone and Either Metformin or Sulfonylurea With Metformin Plus Sulfonylurea on Cardiovascular Endpoints and GlycaemiaNCT00379769 · 10 posted results
- Effects of Vildagliptin/Metformin Combination on Markers of Atherosclerosis, Thrombosis, and Inflammation in Diabetic Patients With Coronary Artery DiseaseNCT01604213