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ACTIV-6: COVID-19 Study of Repurposed Medications - Arm G (Metformin)

ACTIV-6: COVID-19 Outpatient Randomized Trial to Evaluate Efficacy of Repurposed Medications

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT06042855
Enrollment
3214
Registered
2023-09-21
Start date
2023-09-05
Completion date
2024-11-04
Last updated
2025-11-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Covid19

Keywords

SARS-CoV-2, COVID-19, Placebo, Duke University Health System, Outcomes, Duke Clinical Research Institute, ACTIV 6, ACTIV, metformin

Brief summary

The purpose of this study is to evaluate the effectiveness of repurposed medications (study drug(s) in reducing symptoms of non-hospitalized participants with mild to moderate COVID-19. Participants will receive either study drug or placebo. Participants will self-report any new or worsening symptoms or medical events experienced while taking study drug or placebo. This study is intended to be all remote with no in person visits, unless the study team feels it is in the best interest of a participant to be seen in person. Prior and current drug arms are listed on clinicaltrials.gov and will be updated with the activation of any new drug arms. Each study arm will also have its own clinicaltrials.gov entry and will include Pro00107921 in the Unique Protocol ID.

Detailed description

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel betacoronavirus that first emerged in December 2019 and has since caused a global pandemic unseen in almost a century with respect to the number of cases and overall mortality. The clinical disease related to SARS-CoV-2 is referred to as Coronavirus Disease 2019 (COVID-19). Over 2020, advances were made for treatment of COVID-19 and several vaccinations have received emergency use authorization for prevention of SARS-CoV-2 infections. However, the pandemic continues to evolve with new variants and surges of infections in different regions of the world, requiring an ongoing evidence-generating platform, in particular for the treatment of COVID-19 infection in the outpatient setting. This proposed platform protocol can serve as an evidence generating system for prioritized drugs repurposed from other indications with an established safety record and preliminary evidence of clinical efficacy for the treatment of COVID-19. The ultimate goal is to evaluate if repurposed medications can make participants feel better faster and reduce death and hospitalization. This platform protocol is designed to be flexible so that it is suitable for a wide range of settings within healthcare systems and in community settings where it can be integrated into routine COVID-19 testing programs and subsequent treatment plans. This platform protocol will enroll participants in an outpatient setting with a confirmed polymerase chain reaction (PCR) or antigen test for SARS-CoV-2. Participants will be randomized to study drugs or placebo based on the arms that are actively enrolling at the time of randomization. Study drugs may be added or removed according to adaptive design and/or emerging evidence. When there are multiple study drugs available, randomization will occur based on appropriateness of each drug for the participant as determined by the study protocol and investigator and participant equipoise. Each participant will be required to randomize to at least one study drug versus placebo. The probability of placebo to treatment will remain the same regardless of eligibility decisions. Eligible participants will be randomized (1:1), in a blinded fashion, to either the study drug arm or placebo arm in addition to standard of care. As additional study drugs are added, the randomization will be altered to leverage placebo data across arms. Participants will receive a complete supply study drug or placebo with the quantity depending on the study drug/placebo to which they are randomized. All study visits are designed to be remote. However, screening and enrollment may occur in-person at sites and unplanned study visits may occur in-person or remotely, as deemed appropriate by the site investigator for safety purposes. Participants will be asked to complete questionnaires and report safety events during the study. Participants will be prompted by the online system to report safety events and these will be reviewed and confirmed via medical records and site staff, as necessary.

Interventions

OTHERPlacebo

Each study arm will contain a placebo comparator. Placebo will look similar to study drug and will be administered via the same route of administration and dose. However, placebo will be an inactive substance, containing no study drug.

DRUGMetformin

Metformin IR tablets contain the active metformin hydrochloride and inactive ingredients including povidone and magnesium stearate. Commercially available metformin 500 mg tablets will be provided.

Sponsors

National Center for Advancing Translational Sciences (NCATS)
CollaboratorNIH
Vanderbilt University Medical Center
CollaboratorOTHER
Susanna Naggie, MD
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Caregiver)

Masking description

The participant and study teams will know which study drug the participant is allocated to, but will be blinded to study drug versus placebo.

Intervention model description

Double-Blind, Placebo-Controlled, Randomized Trial

Eligibility

Sex/Gender
ALL
Age
30 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Eligibility for overall study are listed below. There may be additional appendix-specific criteria. Inclusion Criteria: * Completed Informed Consent * Age ≥ 30 years old * Confirmed SARS-CoV-2 infection by any authorized or approved polymerase chain reaction (PCR) or antigen test collected within 10 days of screening * Two or more current symptoms of acute infection for ≤7 days. Symptoms include the following: fatigue, dyspnea, fever, cough, nausea, vomiting, diarrhea, body aches, chills, headache, sore throat, nasal symptoms, new loss of sense of taste or smell

Exclusion criteria

* Current or recent (within 10 days of screening) hospitalization for COVID-19 infection * Current or planned participation in another interventional trial to treat COVID-19, at the discretion of the study principal investigator (PI) * Current or recent use (within the last 14 days) of study drug or study drug/device combination * Known allergy/sensitivity or any hypersensitivity to components of the study drug or placebo * Known contraindication(s) to study drug including prohibited concomitant medications * Previous or current enrollment in the ACTIV-6 trial

Design outcomes

Primary

MeasureTime frameDescription
Time to Sustained Recovery in DaysUp to 28 daysTime to sustained recovery was the number of days between receipt of study drug and the third of 3 consecutive days without symptoms. Participants who died, by definition, did not recover regardless of reported symptom freedom. The reported summary is the median survival time.
Number of Participants With Hospitalization or DeathUp to 28 days

Secondary

MeasureTime frameDescription
Number of Participants With Hospitalization, Urgent Care, Emergency Room Visit, or DeathUp to 28 days
Number of Participants at Each Score on the COVID Clinical Progression Scale at Day 7Day 7COVID Clinical Progression Scale is a scale of 0 to 8 where 0 = No clinical or virological evidence of infection, 1 = No limitation of activities, 2 = Limitation of activities, 3 = Hospitalized, no oxygen therapy, 4 = Hospitalized, on oxygen by mask or nasal prongs, 5 = Hospitalized, on non-invasive ventilation or high-flow oxygen, 6 = Hospitalized, on intubation and mechanical ventilation, 7 = Hospitalized, on ventilation + additional organ support (pressors, RRT, ECMO), 8 = Death.
Number of Participants at Each Score on the COVID Clinical Progression Scale at Day 14Day 14COVID Clinical Progression Scale is a scale of 0 to 8 where 0 = No clinical or virological evidence of infection, 1 = No limitation of activities, 2 = Limitation of activities, 3 = Hospitalized, no oxygen therapy, 4 = Hospitalized, on oxygen by mask or nasal prongs, 5 = Hospitalized, on non-invasive ventilation or high-flow oxygen, 6 = Hospitalized, on intubation and mechanical ventilation, 7 = Hospitalized, on ventilation + additional organ support (pressors, RRT, ECMO), 8 = Death.
Number of Participants at Each Score on the COVID Clinical Progression Scale at Day 28Day 28COVID Clinical Progression Scale is a scale of 0 to 8 where 0 = No clinical or virological evidence of infection, 1 = No limitation of activities, 2 = Limitation of activities, 3 = Hospitalized, no oxygen therapy, 4 = Hospitalized, on oxygen by mask or nasal prongs, 5 = Hospitalized, on non-invasive ventilation or high-flow oxygen, 6 = Hospitalized, on intubation and mechanical ventilation, 7 = Hospitalized, on ventilation + additional organ support (pressors, RRT, ECMO), 8 = Death.
Quality of Life (QOL) as Measured by the PROMIS-29 - Physical FunctionDay 7, 14, 28, 90, 120, and 180The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20, where a higher score correlates to better outcome for physical function.
Quality of Life (QOL) as Measured by the PROMIS-29 - FatigueDay 7, 14, 28, 90, 120, and 180The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20, where a higher score correlates to better outcome for fatigue.
Number of Participants With MortalityUp to 28 days
Quality of Life (QOL) as Measured by the PROMIS-29 - DepressionDay 7, 14, 28, 90, 120, and 180The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20, where a lower score correlates to better outcome for depression.
Quality of Life (QOL) as Measured by the PROMIS-29 - AnxietyDay 7, 14, 28, 90, 120, and 180The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20 where a lower score correlates to better outcome for anxiety.
Quality of Life (QOL) as Measured by the PROMIS-29 - SocialDay 7, 14, 28, 90, 120, and 180The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20 where a higher score correlates to better outcome for social roles and activities.
Quality of Life (QOL) as Measured by the PROMIS-29 - SleepDay 7, 14, 28, 90, 120, and 180The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20 where a lower score correlates to better outcome for sleep.
Time Unwell in Days as Measured by the Symptom and Clinical Event ScaleUp to 14 daysThe symptom and clinical event scale is a daily measurement that combines the global symptom burden scale with clinical events hospitalization and mortality. (No symptoms, mild symptoms, moderate symptoms, severe symptoms, hospitalized, deceased). Time unwell was the portion of follow-up (in days) that a participant was symptomatic, hospitalized, or deceased. The quantity is estimated from a Bayesian longitudinal ordinal regression model with covariate adjustment and weakly informative priors.
Mean Days Benefit as Measured by the Symptom and Clinical Event ScaleUp to 14 daysThe symptom and clinical event scale is a daily measurement that combines the global symptom burden scale with clinical events hospitalization and mortality. (No symptoms, mild symptoms, moderate symptoms, severe symptoms, hospitalized, deceased). The cumulative benefit of treatment A is the probability of experiencing a better outcome on treatment A compared to treatment B, summed over the days of follow-up. The difference between the cumulative benefit of treatment A and the cumulative benefit of treatment B is known as the difference in days benefit. Measure of dispersion is 95% credible interval.
Quality of Life (QOL) as Measured by the PROMIS-29 - PainDay 7, 14, 28, 90, 120, and 180The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20, where a lower score correlates to better outcome for pain.
Time to MortalityUp to 28 daysTime to mortality was the number of days between drug receipt and death.

Countries

United States

Participant flow

Participants by arm

ArmCount
Arm G - Metformin
Metformin IR tablets will be self-administered orally according to the following dosing schedule: * 500 mg on Day 1; * 500 mg in the morning and 500 mg in the evening on Day 2 through Day 5; and * 500 mg in the morning and 2 x 500 mg (a total of 1000 mg) in the evening on Day 6 through Day 14. Metformin: Metformin IR tablets contain the active metformin hydrochloride and inactive ingredients including povidone and magnesium stearate. Commercially available metformin 500 mg tablets will be provided.
1,443
Arm G - Placebo
Placebo - appearance and size matched to active study drug. Placebo will be self-administered orally by each participant, with number of tablets matched to active study drug dosing. Placebo: Each study arm will contain a placebo comparator. Placebo will look similar to study drug and will be administered via the same route of administration and dose. However, placebo will be an inactive substance, containing no study drug.
1,548
Total2,991

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdministratively Withdrawn5959
Overall StudyNo Receipt of Study Drug4857

Baseline characteristics

CharacteristicArm G - MetforminArm G - PlaceboTotal
Age, Continuous47.0 years48.0 years47.0 years
Ethnicity (NIH/OMB)
Hispanic or Latino
680 Participants712 Participants1392 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
763 Participants836 Participants1599 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Race
American Indian or Alaska Native
6 Participants4 Participants10 Participants
Race/Ethnicity, Customized
Race
Asian
30 Participants35 Participants65 Participants
Race/Ethnicity, Customized
Race
Black, African American, or African
151 Participants180 Participants331 Participants
Race/Ethnicity, Customized
Race
Middle Eastern or North African
27 Participants20 Participants47 Participants
Race/Ethnicity, Customized
Race
More than one race
38 Participants17 Participants55 Participants
Race/Ethnicity, Customized
Race
Native Hawaiian or Other Pacific Islander
1 Participants3 Participants4 Participants
Race/Ethnicity, Customized
Race
None of the above
31 Participants37 Participants68 Participants
Race/Ethnicity, Customized
Race
No response
5 Participants7 Participants12 Participants
Race/Ethnicity, Customized
Race
Prefer not to answer
25 Participants28 Participants53 Participants
Race/Ethnicity, Customized
Race
White
1129 Participants1217 Participants2346 Participants
Region of Enrollment
United States
1443 Participants1548 Participants2991 Participants
Sex/Gender, Customized
Sex/Gender
Female
918 Participants977 Participants1895 Participants
Sex/Gender, Customized
Sex/Gender
Male
522 Participants566 Participants1088 Participants
Sex/Gender, Customized
Sex/Gender
Prefer not to answer the question
2 Participants4 Participants6 Participants
Sex/Gender, Customized
Sex/Gender
Undifferentiated
1 Participants1 Participants2 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 1,4430 / 1,548
other
Total, other adverse events
4 / 1,4434 / 1,548
serious
Total, serious adverse events
7 / 1,4433 / 1,548

Outcome results

Primary

Number of Participants With Hospitalization or Death

Time frame: Up to 28 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Arm G - MetforminNumber of Participants With Hospitalization or Death4 Participants
Arm G - PlaceboNumber of Participants With Hospitalization or Death3 Participants
Comparison: No hypothesis test or decision rule was evaluated.95% CI: [0.32, 6.38]
Primary

Time to Sustained Recovery in Days

Time to sustained recovery was the number of days between receipt of study drug and the third of 3 consecutive days without symptoms. Participants who died, by definition, did not recover regardless of reported symptom freedom. The reported summary is the median survival time.

Time frame: Up to 28 days

Population: Participants with sustained recovery.

ArmMeasureValue (MEDIAN)
Arm G - MetforminTime to Sustained Recovery in Days9 days
Arm G - PlaceboTime to Sustained Recovery in Days10 days
95% CI: [0.89, 1.03]
Secondary

Mean Days Benefit as Measured by the Symptom and Clinical Event Scale

The symptom and clinical event scale is a daily measurement that combines the global symptom burden scale with clinical events hospitalization and mortality. (No symptoms, mild symptoms, moderate symptoms, severe symptoms, hospitalized, deceased). The cumulative benefit of treatment A is the probability of experiencing a better outcome on treatment A compared to treatment B, summed over the days of follow-up. The difference between the cumulative benefit of treatment A and the cumulative benefit of treatment B is known as the difference in days benefit. Measure of dispersion is 95% credible interval.

Time frame: Up to 14 days

Population: Participants with time unwell.

ArmMeasureValue (MEAN)
Arm G - MetforminMean Days Benefit as Measured by the Symptom and Clinical Event Scale3.27 days
Arm G - PlaceboMean Days Benefit as Measured by the Symptom and Clinical Event Scale3.31 days
Comparison: Analysis is exploratory. No hypothesis test or decision rule was evaluated.95% CI: [-0.34, 0.26]
Secondary

Number of Participants at Each Score on the COVID Clinical Progression Scale at Day 14

COVID Clinical Progression Scale is a scale of 0 to 8 where 0 = No clinical or virological evidence of infection, 1 = No limitation of activities, 2 = Limitation of activities, 3 = Hospitalized, no oxygen therapy, 4 = Hospitalized, on oxygen by mask or nasal prongs, 5 = Hospitalized, on non-invasive ventilation or high-flow oxygen, 6 = Hospitalized, on intubation and mechanical ventilation, 7 = Hospitalized, on ventilation + additional organ support (pressors, RRT, ECMO), 8 = Death.

Time frame: Day 14

Population: Participants who had COVID clinical progression scale data available.

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 144 = Hospitalized, on oxygen by mask or nasal prongs0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 141 = No limitation of activities1237 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 147 = Hospitalized, on ventilation + additional organ support (pressors, RRT, ECMO)0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 143 = Hospitalized, no oxygen therapy1 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 145 = Hospitalized, on non-invasive ventilation or high-flow oxygen0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 148 = Death0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 146 = Hospitalized, on intubation and mechanical ventilation0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 140 = No clinical or virological evidence of infection79 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 142 = Limitation of activities37 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 148 = Death0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 142 = Limitation of activities45 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 143 = Hospitalized, no oxygen therapy0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 147 = Hospitalized, on ventilation + additional organ support (pressors, RRT, ECMO)0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 140 = No clinical or virological evidence of infection80 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 141 = No limitation of activities1333 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 144 = Hospitalized, on oxygen by mask or nasal prongs0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 145 = Hospitalized, on non-invasive ventilation or high-flow oxygen0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 146 = Hospitalized, on intubation and mechanical ventilation0 Participants
Comparison: No hypothesis test or decision rule was evaluated.95% CI: [0.57, 1.41]
Secondary

Number of Participants at Each Score on the COVID Clinical Progression Scale at Day 28

COVID Clinical Progression Scale is a scale of 0 to 8 where 0 = No clinical or virological evidence of infection, 1 = No limitation of activities, 2 = Limitation of activities, 3 = Hospitalized, no oxygen therapy, 4 = Hospitalized, on oxygen by mask or nasal prongs, 5 = Hospitalized, on non-invasive ventilation or high-flow oxygen, 6 = Hospitalized, on intubation and mechanical ventilation, 7 = Hospitalized, on ventilation + additional organ support (pressors, RRT, ECMO), 8 = Death.

Time frame: Day 28

Population: Participants who had COVID clinical progression scale data available.

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 280 = No clinical or virological evidence of infection78 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 281 = No limitation of activities1221 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 285 = Hospitalized, on non-invasive ventilation or high-flow oxygen0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 287 = Hospitalized, on ventilation + additional organ support (pressors, RRT, ECMO)0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 288 = Death0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 282 = Limitation of activities16 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 283 = Hospitalized, no oxygen therapy0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 284 = Hospitalized, on oxygen by mask or nasal prongs0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 286 = Hospitalized, on intubation and mechanical ventilation0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 284 = Hospitalized, on oxygen by mask or nasal prongs0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 280 = No clinical or virological evidence of infection74 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 282 = Limitation of activities22 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 281 = No limitation of activities1322 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 285 = Hospitalized, on non-invasive ventilation or high-flow oxygen0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 283 = Hospitalized, no oxygen therapy0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 287 = Hospitalized, on ventilation + additional organ support (pressors, RRT, ECMO)0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 286 = Hospitalized, on intubation and mechanical ventilation0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 288 = Death0 Participants
Comparison: No hypothesis test or decision rule was evaluated.95% CI: [0.78, 1.42]
Secondary

Number of Participants at Each Score on the COVID Clinical Progression Scale at Day 7

COVID Clinical Progression Scale is a scale of 0 to 8 where 0 = No clinical or virological evidence of infection, 1 = No limitation of activities, 2 = Limitation of activities, 3 = Hospitalized, no oxygen therapy, 4 = Hospitalized, on oxygen by mask or nasal prongs, 5 = Hospitalized, on non-invasive ventilation or high-flow oxygen, 6 = Hospitalized, on intubation and mechanical ventilation, 7 = Hospitalized, on ventilation + additional organ support (pressors, RRT, ECMO), 8 = Death.

Time frame: Day 7

Population: Participants with COVID clinical progression scale data available.

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 78 = Death0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 73 = Hospitalized0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 77 = Hospitalized, on ventilation + additional organ support (pressors, RRT, ECMO)0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 71 = No limitation of activities1230 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 72 = Limitation of activities77 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 74 = Hospitalized, on oxygen by mask or nasal prongs0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 75 = Hospitalized, on non-invasive ventilation or high-flow oxygen0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 76 = Hospitalized, on intubation and mechanical ventilation0 Participants
Arm G - MetforminNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 70 = No clinical or virological evidence of infection90 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 76 = Hospitalized, on intubation and mechanical ventilation0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 72 = Limitation of activities86 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 73 = Hospitalized0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 75 = Hospitalized, on non-invasive ventilation or high-flow oxygen0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 77 = Hospitalized, on ventilation + additional organ support (pressors, RRT, ECMO)0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 78 = Death0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 70 = No clinical or virological evidence of infection94 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 74 = Hospitalized, on oxygen by mask or nasal prongs0 Participants
Arm G - PlaceboNumber of Participants at Each Score on the COVID Clinical Progression Scale at Day 71 = No limitation of activities1307 Participants
Comparison: No hypothesis test or decision rule was evaluated.95% CI: [0.66, 1.31]
Secondary

Number of Participants With Hospitalization, Urgent Care, Emergency Room Visit, or Death

Time frame: Up to 28 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Arm G - MetforminNumber of Participants With Hospitalization, Urgent Care, Emergency Room Visit, or Death54 Participants
Arm G - PlaceboNumber of Participants With Hospitalization, Urgent Care, Emergency Room Visit, or Death49 Participants
Comparison: No hypothesis test or decision rule was evaluated.95% CI: [0.82, 1.78]
Secondary

Number of Participants With Mortality

Time frame: Up to 28 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Arm G - MetforminNumber of Participants With Mortality0 Participants
Arm G - PlaceboNumber of Participants With Mortality0 Participants
Secondary

Quality of Life (QOL) as Measured by the PROMIS-29 - Anxiety

The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20 where a lower score correlates to better outcome for anxiety.

Time frame: Day 7, 14, 28, 90, 120, and 180

Population: Participants with data collected at each timepoint.

ArmMeasureGroupValue (MEDIAN)
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - AnxietyDay 144 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - AnxietyDay 284 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - AnxietyDay 74 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - AnxietyDay 904 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - AnxietyDay 1204 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - AnxietyDay 1804 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - AnxietyDay 1204 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - AnxietyDay 144 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - AnxietyDay 904 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - AnxietyDay 284 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - AnxietyDay 1804 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - AnxietyDay 74 score on a scale
Comparison: Day 795% CI: [0.83, 1.22]
Comparison: Day 1495% CI: [0.76, 1.13]
Comparison: Day 2895% CI: [0.45, 0.8]
Comparison: Day 9095% CI: [0.59, 0.9]
Comparison: Day 12095% CI: [0.61, 0.97]
Comparison: Day 18095% CI: [0.62, 0.94]
Secondary

Quality of Life (QOL) as Measured by the PROMIS-29 - Depression

The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20, where a lower score correlates to better outcome for depression.

Time frame: Day 7, 14, 28, 90, 120, and 180

Population: Participants with data collected at each timepoint.

ArmMeasureGroupValue (MEDIAN)
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - DepressionDay 74 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - DepressionDay 144 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - DepressionDay 284 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - DepressionDay 904 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - DepressionDay 1204 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - DepressionDay 1804 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - DepressionDay 1204 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - DepressionDay 74 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - DepressionDay 904 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - DepressionDay 144 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - DepressionDay 1804 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - DepressionDay 284 score on a scale
Comparison: Day 795% CI: [0.7, 1.09]
Comparison: Day 1495% CI: [0.65, 0.98]
Comparison: Day 2895% CI: [0.47, 0.85]
Comparison: Day 9095% CI: [0.7, 1.08]
Comparison: Day 12095% CI: [0.62, 0.96]
Comparison: Day 18095% CI: [0.61, 0.95]
Secondary

Quality of Life (QOL) as Measured by the PROMIS-29 - Fatigue

The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20, where a higher score correlates to better outcome for fatigue.

Time frame: Day 7, 14, 28, 90, 120, and 180

Population: Participants with data collected at each timepoint.

ArmMeasureGroupValue (MEDIAN)
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - FatigueDay 77 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - FatigueDay 144 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - FatigueDay 284 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - FatigueDay 1204 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - FatigueDay 904 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - FatigueDay 1804 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - FatigueDay 1204 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - FatigueDay 77 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - FatigueDay 284 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - FatigueDay 144 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - FatigueDay 1804 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - FatigueDay 904 score on a scale
Comparison: Day 795% CI: [0.86, 1.15]
Comparison: Day 1495% CI: [0.87, 1.21]
Comparison: Day 2895% CI: [0.58, 0.92]
Comparison: Day 9095% CI: [0.7, 1.02]
Comparison: Day 12095% CI: [0.68, 0.99]
Comparison: Day 18095% CI: [0.7, 1.01]
Secondary

Quality of Life (QOL) as Measured by the PROMIS-29 - Pain

The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20, where a lower score correlates to better outcome for pain.

Time frame: Day 7, 14, 28, 90, 120, and 180

Population: Participants with data collected at each timepoint.

ArmMeasureGroupValue (MEDIAN)
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - PainDay 284 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - PainDay 1804 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - PainDay 904 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - PainDay 144 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - PainDay 1204 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - PainDay 74 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - PainDay 1804 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - PainDay 74 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - PainDay 144 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - PainDay 284 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - PainDay 904 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - PainDay 1204 score on a scale
Comparison: Day 795% CI: [0.7, 1.06]
Comparison: Day 1495% CI: [0.79, 1.14]
Comparison: Day 2895% CI: [0.69, 1.1]
Comparison: Day 9095% CI: [0.8, 1.25]
Comparison: Day 12095% CI: [0.7, 1.08]
Comparison: Day 18095% CI: [0.66, 1.04]
Secondary

Quality of Life (QOL) as Measured by the PROMIS-29 - Physical Function

The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20, where a higher score correlates to better outcome for physical function.

Time frame: Day 7, 14, 28, 90, 120, and 180

Population: Participants with data collected at each timepoint.

ArmMeasureGroupValue (MEDIAN)
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - Physical FunctionDay 9020 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - Physical FunctionDay 1420 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - Physical FunctionDay 12020 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - Physical FunctionDay 18020 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - Physical FunctionDay 2820 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - Physical FunctionDay 720 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - Physical FunctionDay 2820 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - Physical FunctionDay 720 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - Physical FunctionDay 18020 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - Physical FunctionDay 9020 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - Physical FunctionDay 1420 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - Physical FunctionDay 12020 score on a scale
Comparison: Day 795% CI: [0.85, 1.32]
Comparison: Day 1495% CI: [0.85, 1.28]
Comparison: Day 2895% CI: [0.94, 1.53]
Comparison: Day 9095% CI: [0.91, 1.48]
Comparison: Day 12095% CI: [1.06, 1.77]
Comparison: Day 18095% CI: [1.02, 1.66]
Secondary

Quality of Life (QOL) as Measured by the PROMIS-29 - Sleep

The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20 where a lower score correlates to better outcome for sleep.

Time frame: Day 7, 14, 28, 90, 120, and 180

Population: Participants with data collected at each timepoint.

ArmMeasureGroupValue (MEDIAN)
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - SleepDay 79 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - SleepDay 148 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - SleepDay 288 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - SleepDay 908 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - SleepDay 1208 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - SleepDay 1808 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - SleepDay 1208 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - SleepDay 79 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - SleepDay 908 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - SleepDay 148 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - SleepDay 1808 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - SleepDay 288 score on a scale
Comparison: Day 795% CI: [0.96, 1.26]
Comparison: Day 1495% CI: [0.87, 1.14]
Comparison: Day 2895% CI: [0.81, 1.07]
Comparison: Day 9095% CI: [0.76, 1.07]
Comparison: Day 12095% CI: [0.78, 1.06]
Comparison: Day 18095% CI: [0.75, 1.04]
Secondary

Quality of Life (QOL) as Measured by the PROMIS-29 - Social

The PROMIS-29 (Patient-Reported Outcomes Measurement Information System) consists of seven health domains with four 5-level items associated with each and a pain intensity assessment using a 0-10 numeric rank. The seven health domains include physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance. Raw score ranges from 4-20 where a higher score correlates to better outcome for social roles and activities.

Time frame: Day 7, 14, 28, 90, 120, and 180

Population: Participants with data collected at each timepoint.

ArmMeasureGroupValue (MEDIAN)
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - SocialDay 18020 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - SocialDay 2820 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - SocialDay 720 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - SocialDay 9020 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - SocialDay 1420 score on a scale
Arm G - MetforminQuality of Life (QOL) as Measured by the PROMIS-29 - SocialDay 12020 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - SocialDay 1420 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - SocialDay 12020 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - SocialDay 18020 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - SocialDay 720 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - SocialDay 2820 score on a scale
Arm G - PlaceboQuality of Life (QOL) as Measured by the PROMIS-29 - SocialDay 9020 score on a scale
Comparison: Day 795% CI: [0.95, 1.43]
Comparison: Day 1495% CI: [0.87, 1.25]
Comparison: Day 2895% CI: [0.99, 1.59]
Comparison: Day 9095% CI: [0.89, 1.35]
Comparison: Day 12095% CI: [0.98, 1.48]
Comparison: Day 18095% CI: [0.96, 1.46]
Secondary

Time to Mortality

Time to mortality was the number of days between drug receipt and death.

Time frame: Up to 28 days

Population: Data not collected due to no participants having mortality.

Secondary

Time Unwell in Days as Measured by the Symptom and Clinical Event Scale

The symptom and clinical event scale is a daily measurement that combines the global symptom burden scale with clinical events hospitalization and mortality. (No symptoms, mild symptoms, moderate symptoms, severe symptoms, hospitalized, deceased). Time unwell was the portion of follow-up (in days) that a participant was symptomatic, hospitalized, or deceased. The quantity is estimated from a Bayesian longitudinal ordinal regression model with covariate adjustment and weakly informative priors.

Time frame: Up to 14 days

Population: Participants with time unwell.

ArmMeasureValue (MEAN)
Arm G - MetforminTime Unwell in Days as Measured by the Symptom and Clinical Event Scale11.55 days
Arm G - PlaceboTime Unwell in Days as Measured by the Symptom and Clinical Event Scale11.51 days
Comparison: No hypothesis test or decision rule was evaluated.95% CI: [-0.21, 0.28]

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026