Aortic & peripheral vascular disease
Metformin to Improve Walking Performance in Lower Extremity Peripheral Artery Disease: The PERMET Randomized Clinical Trial
Authors' conclusion
Among people with PAD without diabetes, metformin did not improve 6-minute walk distance at 6-month follow-up compared with placebo.
Study context
- Population
- Adults aged ≥50 years with peripheral artery disease (PAD) without diabetes179 (89%) completed 6-month follow-up
- Participants
- 202 adults
- Comparison
- Metformin vs placebo
- Metforminn = 97
- Placebon = 105reference
- Primary endpoint
- Change in 6-minute walk distance (MCID 8 to 20 m)
- Follow-up
- 6 months
Methodological detailsdouble-blind, 4 US centres, 202 of targeted 212 (95%) enrolled
- Double-blind
- 4 US centres
- 202 of targeted 212 (95%) enrolled
Primary result
As reported in the abstract
Adjusted between-group difference
1.1 m
95% CI −16.3 to 18.6
P = 0.90
By group
Metformin
−5.4
within-group change · m
Placebo
−5.3
within-group change · m
Metformin vs Placebo
adjusted between-group difference 1.1 m (95% CI −16.3 to 18.6); P = 0.90
Secondary outcomes
Maximal and pain-free treadmill walking time, WIQ distance and speed, SF-36 physical functioning, brachial artery flow-mediated dilation
- Metformin did not significantly improve any secondary outcome vs placebo
Safety
Serious AEs: CV events (most common)
Nonserious AE: indigestion/stomach upset
Nonserious AE: headache
Original publication
Metformin to Improve Walking Performance in Lower Extremity Peripheral Artery Disease: The PERMET Randomized Clinical Trial. JAMA. Published 3 February 2026. doi:10.
Summarised from the published abstract; every number is checked against it