Metformin to Reduce Airway Glucose in COPD Patients
Status:
Not yet recruiting
Trial end date:
2022-12-01
Target enrollment:
Participant gender:
Summary
Chronic obstructive pulmonary disease (COPD) is the 4th leading cause of death worldwide and
affects 1.2 million people in the UK, costing the NHS >£800 million annually. COPD patients
are more susceptible to bacterial infections and both chronic and acute infections are
common. COPD patients with chronic lung bacterial infection have worse quality of life,
faster disease progression, more symptoms and frequent exacerbations. Acute infections are
the main cause of COPD exacerbations which cause COPD patients to become acutely unwell and
often result in hospitalisation especially in the winter. Antibiotics are frequently used to
treat COPD exacerbations and this contributes to the development of antibiotic resistance.
Therefore there is a need to develop antibiotic-independent approaches to reducing or
preventing bacterial infection in COPD.
The investigators have carried out work in in animal studies and in humans showing that there
is a link between high levels of glucose in the lung and bacterial lung infection. Levels of
glucose in the lung are higher in COPD patients compared with people without COPD. These
higher glucose levels support greater bacterial growth probably because glucose is a nutrient
for bacteria. Therefore reducing airway glucose has the potential to inhibit bacterial growth
in COPD patients.
In animal studies the investigators have demonstrated that the diabetic drug metformin
decreases airway glucose and bacterial growth. The investigators wish to determine if
metformin can achieve the same effects in COPD patients. Metformin is safe and cheap, and has
been extensively used in COPD patients with diabetes with an excellent safety record. The
primary aim of this study will be to determine whether metformin reduces lung glucose in a
small group of non-diabetic COPD patients. If it demonstrates that metformin reduces lung
glucose concentrations it will justify a larger clinical trial of metformin as a treatment
for COPD.