下肢外動脈疾患における歩行能力を改善するメトホルミン: PERMET ランダム化臨床試験
Mary M McDermott1, Kathryn J Domanchuk2, Lu Tian3
1Department of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
JAMA
|November 8, 2025
まとめ
メトホルミンは,糖尿病のない外周動脈疾患 (PAD) の患者に歩行距離を改善しませんでした. この研究では,メトホルミンはPADの患者で歩行能力を高めるのに効果がないことが示されています.
科学分野:
- 心血管医学
- 薬理学について
- 臨床試験
背景:
- 周辺動脈疾患 (PAD) は歩行能力を著しく低下させる.
- PAD患者の歩行能力を改善する効果的な治療法は限られています.
- 糖尿病薬であるメトホルミンは,血管の健康に有益なプラエオトロピー効果がある可能性があります.
研究 の 目的:
- 糖尿病のないPAD患者で6分の歩行距離を改善するメトホルミンの有効性を評価する.
- メトホルミンの効果とプラセボの効果を6ヶ月の追跡期間で比較する.
主な方法:
- ランダム化,ダブルブラインド,プラセボ制御の臨床試験は,米国の4つのセンターで行われました.
- PAD (50歳以上) の202人の参加者は,メトホルミンまたはプラセボを6ヶ月間投与するためにランダムに割り当てられました.
- 主要評価は6分の歩行距離の変化であり,次要評価はトレードミルの歩行時間と生活の質のスコアでした.
主要な成果:
- メトフォーミンはプラセボと比較して,6分間の歩行距離を有意に改善しなかった (調整された差: 1.1 m).
- メトホルミンの使用による二次的なアウトカムでは,有意な改善は見られなかった.
- 一般的な有害事象には,胃腸障害と頭痛が含まれ,重篤な有害事象はグループごとに比較された.
結論:
- PADと糖尿病のない人の歩行能力を改善する効果は示されなかった.
- これらの結果は,この患者集団における歩行能力を改善する治療薬としてメトホルミンの使用を支持しません.
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