Does #metformin reduce hospitalization or not? In a double-blind placebo controlled trial, 28-day data:
NIH guidelines cite the 14-day mITT data where there was not a statistical reduction.
The 14-day and 28-day ITT data also had a statistical reduction in hospitalization.
These numerical complete case data were published in NEJM.
"Through day 28, hospitalization or death occurred in 8 of 596 patients (1.3%) receiving metformin and in 19 of 601 controls (3.2%)"
(2.9% & 1.2% above are by Kaplan-Meier methodology). nejm.org/doi/full/10.10…
While the authors were not allowed to highlight these data or put a p-value in, apparently there are a lot of poeple who can't run a chi-square or fisher's exact test -- as I keep hearing that metformin didn't reduce hospitalization in the COVID-Out trial.
As the cost of metformin is $1, there is no big pharma pushing this med. Most impressive is the 42% reduction in #LongCovid diagnoses shown in a randomized, double-blind trial.
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Let's talk about time of enrollment which reflects real world reality of people seeking testing and then seeking care. With the trial there is an inherent delay to consent, enroll, and ship drug. 44% of participants started within 4 days of symptom onset.
COVID-Out double-blind randomized trial tested #metformin, ivermectin, or fluvoxamine for outpatient #COVID19. Secondary endpoint was incidence of Long Covid (PASC).
Volunteers were followed monthly to 10 mo.
Metformin 42% reduction in Long Covid. medrxiv.org/content/10.110…
Incidence of Healthcare provider diagnosed long covid (PASC) was 42% less among those randomized to #metformin vs. matched placebo.
Hazard Ratio for Long Covid in the metformin group versus control was 0.58 (95% CI 0.38 to 0.88, P=0.009);
There was no benefit for those randomized to #ivermectin vs. matched placebo for reducing long covid and low-dose #fluvoxamine was not beneficial either for decreasing #longcovid.