Metformin in the Treatment of HIV Lipodystrophy Syndrome: A Randomized Controlled Trial [Hadigan C, et al. JAMA 2000; 284: 472]: The authors from Massachusetts General Hospital and the Brigham examined the safety and efficacy of metformin therapy for HIV-infected patients with fat redistribution and abnormal glucose control in a randomized, double-blind, placebo-controlled study. There were 14 patients assigned to metformin, 500 mg twice daily and 12 who received placebo with a duration of three months. The metformin recipients had a decrease in visceral abdominal fat and a reduction in subcutaneous abdominal fat. Other changes in metformin recipients were a significant weight loss, reduced waist circumference and decreased diastolic blood pressure. There was no significant effect on blood lipids. The authors concluded that metformin substantially improves weight, diastolic pressure and hyperinsulinemia.
Comment: This is an interesting and potentially important report, but the authors view it as a "pilot study" due to the relatively small number of patients. posted 8/7/2000