Metformin for Achilles Tendinopathy

This trial explores whether metformin, a common diabetes medication, can alleviate chronic Achilles tendon pain and enhance tendon healing. Participants will receive either metformin capsules or placebo pills for 16 weeks, alongside a home exercise program. The trial aims to compare the effectiveness of metformin to a placebo. Individuals with ongoing Achilles tendon pain (also known as Achilles tendinopathy) who have not had recent interventions or surgeries may be suitable candidates for this study. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, providing participants an opportunity to contribute to groundbreaking medical research.

The trial requires that you stop taking certain medications, such as diabetic medications like sitagliptin and carbonic anhydrase inhibitors like topiramate. If you are currently taking metformin or have taken it in the last 6 months, you cannot participate.

Research has shown that metformin is generally safe for use. One study found that metformin can help protect tendons from damage by activating a specific process in the body, suggesting it might be a safe option for treating tendon problems. As a common drug for managing diabetes, much is known about its safety. Most people taking metformin experience few side effects, though some might have mild stomach issues. However, this trial is in its early stages, so while metformin appears promising, researchers are still studying its effects on Achilles tendon pain.¹²³⁴⁵

Unlike the standard treatments for Achilles tendinopathy, which often include physical therapy, NSAIDs, or corticosteroid injections, metformin offers a novel approach by leveraging its anti-inflammatory and metabolic effects. Metformin, commonly known for managing diabetes, may help reduce inflammation and improve tendon healing, which is a new mechanism for this condition. Researchers are excited because this approach could offer a non-invasive and potentially more effective treatment option, addressing the root causes of tendinopathy rather than just alleviating symptoms.

Research suggests that metformin might help with Achilles tendon pain. In animal studies, metformin injections prevented tendon problems and reduced swelling in the Achilles tendon by blocking a protein that causes inflammation. While these results are promising, they mostly come from animal studies. This trial will compare the effects of metformin with a placebo in people with long-term Achilles tendon pain to study its effectiveness in humans.¹²⁴⁶⁷