A cheap diabetes drug is currently being assessed for its potential to halt the progression of a life-threatening condition.
Scientists are assessing whether metformin can be repurposed to treat abdominal aortic aneurysms (AAA).
In the UK, a farmer from Leicestershire has become the first participant in a trial designed to evaluate whether metformin can benefit individuals suffering from this condition.
An AAA manifests as a balloon-like swelling within the aorta, which transports blood from the heart to the abdomen.
While many aneurysms remain asymptomatic, larger formations pose a critical risk of rupture, a complication that can prove fatal.
These abdominal aortic aneurysms are tragically linked to approximately 4,000 deaths annually across the UK.
Philip Gosling, 80, was told that his AAA was too small for treatment.
When he asked what he could do to stop it growing, he was told about the new trial, funded by the British Heart Foundation (BHF), which is assessing whether or not the diabetes drug metformin could halt the growth of AAAs.
He was the first to join the UK arm of the trial, which is being conducted by experts from the UK, Australia and New Zealand.
“I’m glad to be on the trial,” he said.
“I believe in research, I see the results of it every day on the farm, where science has changed things so much from when I started. When they told me about the trial I had to get involved.”
Mr Gosling was referred to a specialist after routine screening detected his AAA.
Screening is offered to all men over the age of 64 because they are at highest risk of the condition.
If an AAA is small, patients will not be given treatment but they will be given regular scans to check on its size.
If an aneurysm grows, the risk of it bursting becomes higher.
Once it grows to a certain size then a patient will be referred to a specialist to discuss treatment options.
“My aneurysm is 4cm wide, so isn’t big enough to operate on. I asked what I could do to stop it growing, and that’s when they told me about the trial,” Mr Gosling said.
Mr Gosling, who still helps his son on the family farm, said that the condition means he had to stop doing certain things, such as lifting heavy objects.
The trial, backed by a £1.2 million BHF grant, is the largest ever drug trial for AAA and aims to recruit 1,000 patients over two years.
Men and women with a small AAA who take part in the trial will be given metformin or placebo tablets daily until their AAA needs surgical repair, usually at least two years.
Mr Gosling started the first stage of the trial in July, where he was given metformin in gradually larger doses over six weeks to make sure he could tolerate the drug.
He is now on the second stage, where he is taking either metformin or a placebo and having regular check-ups to see if his AAA is growing.
“My condition is very closely monitored, which can only be a good thing,” Mr Gosling said.
“Hopefully it will help a lot of people like me in the future.”
It is hoped that by slowing or preventing aneurysm growth patients could avoid major AAA surgery, which carries its own risks.
Professor Matt Bown, BHF professor of vascular surgery at the University of Leicester, who is leading the UK branch of the trial, said: “Evidence suggests metformin could be the treatment for AAA we’ve long been looking for.
“Research in the lab indicates it could be working to prevent AAA growth by blocking inflammation in the aorta, a key factor that causes AAA enlargement.
“This trial will involve people who can currently do nothing but wait for their aneurysm to grow to a dangerous size.
“We hope we will prove that daily metformin can be used to treat this group and give them some much-needed peace of mind.”
Professor Bryan Williams, chief scientific and medical officer at the BHF, added: “Abdominal aortic aneurysm increases the risk of rupture of this major blood vessel which can have catastrophic consequences.
“The risk of rupture increases as the size of the aneurysm increases and to date we don’t have effective drug treatments to limit the expansion of these aneurysms.
“This is the reason the BHF is supporting this important trial to determine whether a commonly available medication, metformin, usually used for the treatment of diabetes, can limit the expansion of these aneurysms and thus, reduce the risk of rupture.
“This important clinical trial will reveal whether this simple treatment can stop aneurysm growth and, if it does, this would be a major breakthrough, providing reassurance for patients affected by this condition.”
