๐Ÿ›๏ธ Verified NIH Record โ€ข Updated 2026-08-07

Metformin in Alzheimer's Dementia Prevention (NCT04098666)

๐Ÿ”ต Active, Not Recruiting Phase2 / Phase3 ๐Ÿ’Š Investigational Drug / Biologic Sponsor: Columbia University

๐Ÿฉบ Plain-English Summary (8th-Grade Level)

MAP will be a multi-center phase 2/3 1:1 randomized controlled trial (RCT) of long-acting metformin (reduced mass Glucophage XR) vs. matching placebo in 326 men and women with early and late aMCI, without diabetes, not treated with metformin, overweight or obese, aged 55 years to 90 years. The RCT will last 18 months and have 4 visits: baseline, 6-months, 12-months, and 18-months. The RCT will be preceded by a screening phase followed by randomization and a titration period in which drug/placebo will be titrated from 500 mg a day (one tablet) to 2,000 mg a day (4 tablets), in increments of 500 mg (one tablet) every 10 days. Participants will remain in the RCT on the tolerated dose, and included in analyses on an intent to treat basis. We expect the attrition rate to be 10%/year. Neuropsychological battery, clinical interviews, physical exam, and phlebotomy will be conducted at baseline and every 6 months. Brain MRI will be conducted in approximately half of the participants (186) twice, at baseline, and after the last study visit at month 18. We will also conduct brain amyloid Positron Emission Tomography (PET) using 18F-Florbetaben, and tau PET using 18F-MK6240 in half of the participants at baseline and end of the RCT. The primary clinical outcome of the study will be changes in the Free and Cued Selective Reminding Test. The secondary endpoints are 1) changes in global cognitive performance, measured with the Alzheimer's Disease Cooperative Study Preclinical Alzheimer Cognitive Composite (ADCS-PACC); 2) changes in neurodegeneration, ascertained as cortical thickness in areas affected by AD on brain MRI; 3) changes in cerebrovascular disease, ascertained as white matter hyperintensities (WMH) volume on brain MRI; 4) Changes in whole brain amyloid รŸ (AรŸ) SUVR and in incident amyloid positivity; 5) Changes in tau SUVR in a composite brain region comprising medial and inferolateral temporal cortex; 6) Changes in plasma AD biomarkers. The data coordinating center and Imaging Core is located at John Hopkins University. The PET coordinating center is located at UC-Berkeley. The Clinical Coordinating and Monitoring Center and the central laboratory will be located at Columbia. The Research pharmacy function will be shared by the University of Rochester, which will dispense randomization kits, and the University of Iowa, which will receive bulk metformin and identical matching placebo from EMD Serono.

Who can join: To join this study, participants generally need to meet the listed inclusion criteria (23 items) and avoid the listed exclusions (25 items).

Location: University of California - Irvine โ€” Irvine, California

๐Ÿ“‹ "Do I Qualify?" โ€” 1-Minute Self Screener

Instant Checklist

Check every box below. If you can check all of them, you may meet the study's basic screening requirements (final eligibility is confirmed by the site team).

Usually NOT eligible if any of the following apply:

  • Exclusion Criteria:
  • Use of metformin or any class of medication approved for treatment of diabetes, even if it is used for an indication other than diabetes (e.g., obesity), within one year of screening. These medications include GLP-1 agonists used for weight loss.
  • Body mass index โ‰ค 20 k/m2.
  • Metformin is contraindicated in persons with an estimated glomerular filtration rate (eGFR) of less than 30 mL/min. For persons with an eGFR of 30 to 45 mL/min, a reduction of the dose or discontinuation of the medication is recommended for those on metformin; in this range, it is also recommended that persons do not initiate metformin. Thus, participants with eGFR โ‰ค 45 mL/min will not be eligible to participate.
  • The risk of lactic acidosis is increased in persons with liver disease and class III or IV congestive heart failure. Thus, persons with liver disease other than non-alcoholic fatty liver disease or class III or IV congestive heart failure will not be eligible to participate due to the risks of side effects.
  • A history of intolerance to metformin.
  • History of cerebrovascular accident with residual neurological deficits.
  • Moderate to severe depression, indicated by a score in the Geriatric Depression Scale of 9/15 or higher.
  • Dementia diagnosis
  • Lack of capacity to consent
  • Participants with neurologic diseases associated with neurologic deficits on clinical examination.
  • Participants with other current Axis I psychiatric diagnoses such as bipolar disorder or schizophrenia.

๐Ÿ” Extracted verbatim from the official NIH eligibility criteria. Always confirm with the study coordinator.

๐Ÿ“ All Participating Trial Locations (22 Sites)

  • University of California - Irvine โ€” Irvine, California
  • Stanford University โ€” Palo Alto, California
  • Georgetown University โ€” Washington D.C., District of Columbia
  • University of Miami โ€” Miami, Florida
  • Emory University โ€” Atlanta, Georgia
  • Rush University Medical Center โ€” Chicago, Illinois
  • University of Kansas Medical Center โ€” Wichita, Kansas
  • Pennington Biomedical Research Center โ€” Baton Rouge, Louisiana
  • Boston University โ€” Boston, Massachusetts
  • University of New Mexico โ€” Albuquerque, New Mexico
  • University at Buffalo โ€” Buffalo, New York
  • New York University Langone Medical Center โ€” New York, New York
  • Columbia University Medical Center โ€” New York, New York
  • Cornell University โ€” New York, New York
  • SUNY Upstate Medical University โ€” Syracuse, New York
  • Wake Forest University Health Sciences โ€” Winston-Salem, North Carolina
  • University of Cincinnati โ€” Cincinnati, Ohio
  • University of Texas - Southwestern Medical Center โ€” Dallas, Texas
  • The University of Texas Health Science Center San Antonio โ€” San Antonio, Texas
  • Eastern Virginia Medical School โ€” Norfolk, Virginia
  • University of Washington โ€” Seattle, Washington
  • Medical College of Wisconsin โ€” Milwaukee, Wisconsin

๐Ÿ’ฐ Cost, Insurance & Patient Rights

  • 100% Free Items: The investigational treatment and protocol-required procedures are supplied at zero cost by the sponsor.
  • Routine Patient Care: Under federal law (ACA ยง 2709) and many state statutes, routine care costs are covered during participation.
  • Voluntary Participation: You may withdraw at any time without affecting your standard medical care.
๐Ÿ›๏ธ View Official NIH Record โ†—