Conv. Plasma
Nigella Sativa
Nitric Oxide
Peg.. Lambda

Home   COVID-19 treatment studies for Metformin  COVID-19 treatment studies for Metformin  C19 studies: Metformin  Metformin   Select treatmentSelect treatmentTreatmentsTreatments
Melatonin Meta
Bromhexine Meta Metformin Meta
Budesonide Meta Molnupiravir Meta
Cannabidiol Meta
Colchicine Meta Nigella Sativa Meta
Conv. Plasma Meta Nitazoxanide Meta
Curcumin Meta Nitric Oxide Meta
Ensovibep Meta Paxlovid Meta
Famotidine Meta Peg.. Lambda Meta
Favipiravir Meta Povidone-Iod.. Meta
Fluvoxamine Meta Quercetin Meta
Hydroxychlor.. Meta Remdesivir Meta
Iota-carragee.. Meta
Ivermectin Meta Zinc Meta
Lactoferrin Meta

Other Treatments Global Adoption
All Studies   Meta Analysis   Recent: 
0 0.5 1 1.5 2+ Mortality, day 28 3% Improvement Relative Risk Mortality, day 14 -197% Death/hospitalization 52% Progression 40% Progression (b) 12% primary Bramante et al. NCT04510194 COVID-OUT Metformin RCT EARLY Favors metformin Favors fluvoxamine ..
Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19
Bramante et al., NEJM, doi:10.1056/NEJMoa2201662, COVID-OUT, NCT04510194 (history)
18 Aug 2022    Source   PDF   Share   Tweet
COVID-OUT remotely operated RCT, showing lower combined ER/hospitalization/death with metformin. Results for other treatments are listed separately - ivermectin, fluvoxamine.
The "control" group includes patients receiving active treatments fluvoxamine and ivermectin.
Control arm results are very different between treatments, for example considering hospitalization/death, this was 1.0% for ivermectin vs. 2.7% for overall control, however it was 1.3% for the ivermectin-specific control. 394 control patients are shared. The rate for the non-shared 261 metformin control patients is 5%, compared to 1.3% for ivermectin control patients. The metformin arm started earlier, however it is unclear why the difference in outcomes is so large.
Results were delayed for 6 months with no explanation, with followup ending Feb 14, 2022.
Adherence was very low, with 77% overall reporting 70+% adherence. Numbers for 100% adherence are not provided.
Multiple outcomes are missing, for example time to recovery (where ACTIV-6 showed superiority of ivermectin).
Treatment was 14 days for metformin and fluvoxamine, but only 3 days for ivermectin.
Trial outcomes were changed on January 20, 2022 [], and again on March 2, 2022 [ (B)]. COVIDOUT.
Medication delivery varied significantly over the trial. In this presentation [], author indicates that delivery was initially local, later via FedEx, was much slower in August, there were delays due to team bandwidth issues, and they only realized they could use FedEx same day delivery in September.
risk of death, 2.9% lower, RR 0.97, p = 1.00, treatment 1 of 408 (0.2%), control 1 of 396 (0.3%), NNT 13464, day 28.
risk of death, 197.1% higher, RR 2.97, p = 1.00, treatment 1 of 408 (0.2%), control 0 of 396 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm), day 14.
risk of death/hospitalization, 52.3% lower, RR 0.48, p = 0.09, treatment 8 of 652 (1.2%), control 18 of 655 (2.7%), NNT 66, odds ratio converted to relative risk.
risk of progression, 40.2% lower, RR 0.60, p = 0.03, treatment 27 of 652 (4.1%), control 48 of 655 (7.3%), NNT 31, odds ratio converted to relative risk, combined ER, hospitalization, death.
risk of progression, 12.1% lower, RR 0.88, p = 0.18, treatment 154 of 652 (23.6%), control 179 of 653 (27.4%), NNT 26, odds ratio converted to relative risk, combined hypoxemia, ER, hospitalization, death, primary outcome.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Bramante et al., 18 Aug 2022, Double Blind Randomized Controlled Trial, placebo-controlled, USA, peer-reviewed, 3 authors, average treatment delay 4.8 days, this trial compares with another treatment - results may be better when compared to placebo, trial NCT04510194 (history) (COVID-OUT).
All Studies   Meta Analysis   Submit Updates or Corrections
This PaperMetforminAll
Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
  or use drag and drop