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RECRUITING

NCT05515978

EARLY_PHASE1

Pragmatic Trial of Metformin for Glucose Intolerance or Increased BMI in Prostate Cancer Patients

Sponsor: University of Colorado, Denver

View on ClinicalTrials.gov

Summary

Metformin is used widely in the treatment of type 2 diabetes. It has off-label indications for use in the prevention of diabetes and in hyperinsulinar obesity. In medical practices, the implementation of metformin for these off-label indications is variable, often at the level of the provider. Multiple retrospective investigations have also shown a clinical benefit in men with prostate cancer who are incidentally treated with metformin. This pragmatic study will test the feasibility of enrolling patients who have glucose intolerance (as defined by HbA1c of 5.7-6.4%) and/or who have increased BMI (BMI greater than or equal to 25 kg/m2) to a randomized pragmatic study of metformin plus lifestyle modification information versus lifestyle modification information only. For purposes of the scope of this project and the study's feasibility, this will be implemented in a group of prostate cancer patients, who may have additional benefits from metformin.

Official title: A Randomized, Pragmatic, Adaptive Trial of Metformin for Glucose Intolerance or Increased Body Mass Index in Prostate Cancer Patients

Key Details

Gender

MALE

Age Range

18 Years - Any

Study Type

INTERVENTIONAL

Enrollment

100

Start Date

2022-10-10

Completion Date

2036-11-06

Last Updated

2025-12-04

Healthy Volunteers

Conditions

Prostate Cancer

Interventions

DRUG

Metformin

Metformin is a medication used to treat type 2 diabetes, gestational diabetes, and prediabetes. In this study, patients on the Metformin arm will be started on 850 mg daily for 2 weeks, then escalated to a final dose of 850 mg twice daily, which is lower than the maximum recommended dose of 2550 mg total daily.

BEHAVIORAL

Lifestyle Modification

Patients randomized to this arm will receive standard lifestyle modification recommendations. This will include the general recommendation to increase exercise level mildly, after discussing with the medical provider. There is a potential low-level risk in increasing one's exercise levels. Here are some examples of the educational material from the American Diabetes Association website, and topics will be rotated on quarterly basis: Healthy eating: https://www.diabetes.org/nutrition/healthy-food-choices-made-easy Prediabetes: https://www.diabetes.org/diabetes-risk/prediabetes Fitness: https://www.diabetes.org/fitness/get-and-stay-fit Weight loss: https://www.diabetes.org/fitness/weight-loss

Inclusion Criteria: In order to be eligible to participate in this study, an individual must meet all of the following criteria. The patients will be screening for eligibility and offered an electronic consent via the Epic medical record and the patient portal (My Health Connection - MHC) or otherwise through Epic: 1. Provision to sign and date the consent form in MHC or otherwise via Epic. 2. Subjects must have an MHC Account to participate in the study 3. Be a male aged ≥18 years of age on day of signing the informed consent. 4. Impaired glucose tolerance and/or overweight, and appropriate to receive metformin, meeting at least one of the following in the last year (timing relative to the consent presentation not start of therapy): * HbA1c of 5.7 - 6.4 % * BMI≥25 kg/m\^2 5. Have a prostate cancer diagnosis 6. Have a clinical relationship with a participating provider at a UCHealth facility. Exclusion Criteria: 1. On therapy for diabetes including any of the following alone or in combination medications (diet controlled or managed diabetes is allowed - e.g. diagnosis of Diabetes, but without an active prescription for anti-glycemic medication): 1. Metformin 2. Insulin 3. Glipizide 4. Glyburide 5. Glimepiride 6. Pioglitazone 7. Rosiglitazone 8. Sitagliptin 9. Saxagliptin 10. Linagliptin 11. Alogliptin 12. Canagliflozin 13. Dapagliflozin 14. Empagliflozin 15. Ertugliflozin 16. Liraglutide 17. Dulaglutide 18. Semaglutide 19. Exenatide 20. Lixisenatide 21. Nateglinide 22. Repaglinide 23. Tirzepatide 2. Contraindication for metformin use which include any of the following which are exclusionary (in Epic will use most recent lab values): 1. Estimated glomerular filtration rate (eGFR) of \< 50 ml/minute (calculated according to the formula utilized within Epic). 2. Known Total Bilirubin ≥3 mg/dL) 3. Diagnosis of fibrosis or cirrhosis of the liver (ICD10: K74) 4. Diagnosis of alcohol related disorders (ICD10: F10) 5. Metformin allergy in Epic (ICD10: T50.995A) 3. Non-English-speaking patient until Spanish language consent form and relevant materials can be made available. Due to the novel aspect of this trial, we plan to get some experience in treating approximately the first 50 patients, make any changes needed in the study operations and then implement a Spanish consent, as feasible. 4. Taking any medication with a known class D or higher drug interaction with metformin, including: 1. Cimetidine 2. Dolutegravir 3. Patiromer 4. Ranolazine 5. Tafenoquine 5. The use of any carbonic anhydrase inhibitors since they are a risk factor for lactic acidosis, including: 1. Topiramate 2. Dichlorphenamide 3. Acetazolamide 4. Methazolamide 5. Dorzolamide 6. Brinzolamide 7. Dichlorphenamide 8. Sultiame 9. Zonisamide 10. Indisulam 6. Any treating investigator concern, related to tolerance, safety, adherence or for any other reason

Locations (4)

Colorado Research Center

Aurora, Colorado, United States

UCHealth-Southern Colorado

Colorado Springs, Colorado, United States

UCHealth-Metro Denver

Denver, Colorado, United States

UCHealth-Northern Colorado

Fort Collins, Colorado, United States