Metformin
Metfromin (MF) which is the most commonly used antidiabetic medications has been found to activate the AMP-activated protein kinase (AMPK) in intact cells and in vivo. Preclinical data shows that an "MCD-like" pathology with podocyte injury/FPE transitioned to podocytopenia and FSGS by AMPK inhibition, while AMPK activation with MF mitigated podocytopenia in FSGS models.
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How is Metfromin being studied in FSGS?
30 participants will be randomized in a phase 2 placebo controlled, double blind, RCT to test MF (in addition to standard-of-care) for FSGS requiring immunosuppressive therapy. The intervetion group will receive Metformin 500 mg tablets with standard of care for 6 months vs matched placebo in the control group. The study is designed to evaluate eGFR and proteinuria outcomes as exploratory markers of efficacy and evaluate safety of MF therapy in FSGS.
Eligibility Criteria
Participants must be 18 years of age or older, but =or <80 years of age at the time of the informed consent
Kidney Biopsy confirming FSGS
Therapeutic plan by treating physician for treatment using glucocorticoids
eGFR of >30 ml/min/m 2
Related publications:
https://www.kireports.org/article/S2468-0249(24)00095-0/fulltext