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Last update 19 Oct 2026

Metformin Hydrochloride

Last update 19 Oct 2026

Overview

R&D Status

Clinical Result

Translational Medicine

Overview

Basic Info

SummaryMetformin Hydrochloride, sold under the trade name GLUCOPHAGE, is a medication used in the treatment of type 2 diabetes mellitus. It was first approved in France in 1957 and is now manufactured by Bristol Myers Squibb Co. GLUCOPHAGE works by activating PRKAB1, which helps to improve glycemic control in both adult and pediatric patients aged 10 years and older, when used in combination with diet and exercise. This medication is a biguanide, and it is commonly used as an adjunct therapy to help manage blood sugar levels in individuals with type 2 diabetes.

Drug Type

Small molecule drug

Synonyms

Meiformin Hydrochloride, Metformin hydrochloride (JP17/USP), Metformin Hydrochlorride

+ [67]

Target

PRKAB1

Action

activators

Mechanism

PRKAB1 activators(Protein kinase AMP-activated non-catalytic subunit beta 1 activators)

Therapeutic Areas

Endocrinology and Metabolic DiseaseNeoplasmsImmune System Diseases+ [11]

Active Indication

Diabetes Mellitus, Type 2Invasive Mammary CarcinomaChronic Disease+ [40]

Inactive Indication

Acinar Cell CarcinomaAcquired Immunodeficiency SyndromeAdenocarcinoma of large intestine+ [81]

Originator Organization

Bristol Myers Squibb Co.

Active Organization

University of Milan

City of Hope National Medical Center

National Cancer Institute

+ [25]

Inactive Organization

Rutgers State University of New Jersey

The Case Comprehensive Cancer Center

Turning Point Therapeutics, Inc.

+ [33]

License Organization

Merck KGaA

The Fox Chase Cancer Center

Sylvester Comprehensive Cancer Center

+ [3]

Drug Highest PhaseApproved

First Approval Date

China (01 Jan 1992),

Diabetes Mellitus, Type 2

RegulationPriority Review (China)

Structure/Sequence

Molecular FormulaC4H12ClN5

InChIKeyOETHQSJEHLVLGH-UHFFFAOYSA-N

CAS Registry1115-70-4

3,057

Clinical Trials associated with Metformin Hydrochloride

CTRI/2025/09/094234

/ Not yet recruitingPhase 2IIT

A Feasibility Study Comparing a Unani Regimen and Metformin in the management of Type 2 Diabetes Mellitus - NIL

Start Date01 Oct 2027

Sponsor / Collaborator-

TCTR20260910019

/ Not yet recruitingPhase 1IIT

A Bioequivalence study of a randomized, single dose, two-way crossover design with two-period, two-treatment, and two-sequence of Dapagliflozin/Metformin 10/500 mg tablets relative to XIGDUO XR (TABLETS 10 MG/500 MG) in healthy Thai participants under fed condition

Start Date09 Feb 2027

Sponsor / Collaborator-

ACTRN12619001559101

/ Not yet recruitingPhase 4IIT

A double-blind, randomised placebo-controlled clinical trial using metformin as an adjunct to a healthy lifestyle behavioural intervention to improve cardiometabolic outcomes and affective syndromes in youth with clinically diagnosed mood and psychotic syndromes

Start Date02 Feb 2027

Sponsor / Collaborator

University of Sydney Union

100 Clinical Results associated with Metformin Hydrochloride

100 Translational Medicine associated with Metformin Hydrochloride

100 Patents (Medical) associated with Metformin Hydrochloride

16,007

Literatures (Medical) associated with Metformin Hydrochloride

01 Feb 2027·COMPUTATIONAL BIOLOGY AND CHEMISTRY

COPD-associated oxidative phosphorylation and electron transfer chain rewiring in circulating neutrophils and its relation to exacerbation and cognitive impairment

Article

Author: Mehrabi, Masomeh ; Amani, Mojtaba ; Azim, M Kamran ; Shabani-Mashcool, Soheila ; Kavousi, Kaveh ; Khodarahmi, Reza ; Beglari, Farzin ; Ghobadi, Hassan

INTRODUCTION:

Chronic obstructive pulmonary disease (COPD) is an inflammatory disorder linked to increased oxidative stress. Oxidative phosphorylation (OXPHOS) and electron transport chain (ETC) activity in circulating neutrophils generate reactive oxygen species (ROS), potentially associated with disease exacerbation and cognitive impairment. This study aimed to identify OXPHOS-related hub genes in neutrophils, investigate COPD-associated network rewiring, and assess their associations with disease progression and neurodegeneration.

MATERIALS AND METHODS:

Gene expression data from GSE278206 were analyzed using weighted gene co-expression network analysis (WGCNA) in R to identify co-expression modules. Functional enrichment (GO and KEGG) was performed with clusterProfiler. Correlation rewiring was assessed using Hmisc and Fisher's z-transformation test. Protein-protein interaction (PPI) networks were constructed via STRING database (v12) and Cytoscape (v3.10.3), with MCODE (v2.0.3) for module detection and ClueGO (v2.5.10) for functional annotation. Drug-gene interactions were explored using the drug-gene interaction database (DGIdb).

RESULTS:

The turquoise module exhibited strong positive correlations with COPD in males (r = 0.93, adjusted p = 0.03) and females (r = 0.45, adjusted p = 2.48 × 10⁻⁶) and was enriched in OXPHOS/ETC genes. COPD-associated network rewiring showed strengthened correlations, particularly involving COX7A2P2, with potential inhibition by Metformin hydrochloride, ME-344, NV-128, and HET0016. OXPHOS genes displayed strong rewiring inflammatory response genes (notably IL6ST) and neutrophil activation genes (notably PREX1) in COPD versus controls.

CONCLUSION:

OXPHOS- and ETC-related hub genes in circulating neutrophils are associated with COPD-associated transcriptional rewiring, with COX7A2P2 emerging as a strong candidate, potentially contributing to incident COPD and therapeutic targets.

01 Nov 2026·PHYTOMEDICINE

Chemical characterization and pharmacological mechanisms of Qizhi Yishen Capsule in early diabetic kidney disease

Article

Author: Duan, Wenna ; Shang, Guichun ; Zhang, Yongqing ; Liu, Yan ; Jiang, Qiu ; Liu, Jingbo

OBJECTIVE:

This research explored the bioactive components and therapeutic mechanisms of Qizhi Yishen Capsule (QZC) in managing early-stage diabetic kidney disease (DKD) by integrating network pharmacology with experimental evidence, aiming to support its clinical utility with scientific validation.

METHODS:

Network pharmacology and molecular docking were utilized to identify QZC's potential targets in DKD treatment. The therapeutic impact of QZC on renal damage in DKD rats was assessed through in vivo tests, including serum biochemistry, histological staining, and transmission electron microscopy analysis.Potential mechanisms were further explored through metabolomics, in vitro experiments, qRT-PCR, and Western blot analysis.

RESULTS:

The renal protective effects of QZC in DKD were predicted to be mediated via signaling pathways such as PI3K-Akt, AMPK, and MAPK, based on network pharmacology analysis. In vivo studies confirmed that QZC (509 mg·kg^-1), in combination with metformin hydrochloride tablets (MET, 104 mg kg^-1), significantly alleviated pathological renal injury and improved podocyte ultrastructure in DKD rats. Metabolomics analysis identified 420 candidate biomarkers, of which 157 were upregulated in the DKD model group and downregulated after QZC treatment, and 263 showed the opposite trend. These metabolites were mainly involved in starch and sucrose metabolism, tyrosine metabolism, phenylalanine metabolism, cysteine and methionine metabolism, and the biosynthesis of phenylalanine, tyrosine, and tryptophan. In vitro assays demonstrated that QZC (300 μg ml^-1), gamma-linolenic acid (GLA, 12 μmol L^-1), and methyl caffeate (MC, 12 μmol L^-1)-two active constituents of QZC-significantly inhibited apoptosis in HK-2 cells, regulated the cell cycle, and reduced reactive oxygen species (ROS) levels. qRT-PCR and Western blot analyses indicated that QZC activated AMPK, SIRT1, and PGC-1α expression at the mRNA and protein levels.

CONCLUSION:

QZC improves hyperglycemia-induced tubular injury and metabolic disorders in DKD rats by suppressing oxidative stress and apoptosis through multi-component and multi-target regulation of the AMPK/SIRT1/PGC-1α signaling pathway. This study integrates network pharmacology, metabolomics, and experimental validation to systematically elucidate, for the first time, the multi-component basis and the AMPK/SIRT1/PGC-1α pathway mechanism underlying QZC's efficacy against early DKD.

20 Aug 2026·CHINESE MEDICAL JOURNAL

Therapeutic effect of metformin on reversing gastric intestinal metaplasia

Article

Author: Zhu, Xiaojing ; Lin, Kexin ; Li, Songbo ; Zhang, Lifeng ; Qu, Xiaodong ; Yao, Nuo ; Shi, Yongquan ; Zhao, Xingyu ; Wang, Na ; Li, Xuezhi ; Chen, Min

Abstract:

Background::

Currently, standard therapeutic agents are not available for treating gastric intestinal metaplasia (IM). However, emerging evidence suggests the potential efficacy of metformin in addressing this issue. Our aim was to assess the efficacy and safety of metformin in reversing IM.

Methods::

We initially investigated the impact of metformin on reversing gastric IM in mice. An open-label, prospective, randomized controlled trial was subsequently conducted at a tertiary hospital in China from April 2022 to May 2023. A total of 140 nondiabetic patients with pathologically confirmed IM and negative Helicobacter pylori tests were recruited. Patients were randomly assigned at a 1:1 ratio to receive either 500 mg of metformin daily for six months or 5 mg of folate three times daily as a control. The primary outcome was defined as the regression rate of IM in different groups at the end of the treatment.

Results::

Metformin improved gastric mucosal pathology in mice. A total of 158 patients were screened, 140 of whom were randomized to the two groups. Among these, 85/140 (60.7%) were male, and the mean age was 55.9 ± 8.3 years. Six-month follow-up data were available for 129 patients. Compared with folate users (control group), metformin users had a greater rate of regression of IM (48.6% [34/70] vs. 31.4% [22/70]; relative risk [RR] = 1.55, 95% confidence interval [CI] 1.01–2.36; P = 0.04) in the intention-to-treat population. Furthermore, in the per-protocol population, metformin users had a higher rate of regression of IM (53.1% [34/64] vs. 33.9% [22/65]; RR = 1.57, 95% CI 1.04–2.37; P = 0.03). The metformin group had a low incidence of self-alleviating mild adverse reactions.

Conclusion::

This randomized clinical trial revealed that metformin can be safely administered to promote the regression of IM in nondiabetic individuals without Helicobacter pylori infection.

Registration::

ClinicalTrials.gov, Identifier: NCT05288153.

470

News (Medical) associated with Metformin Hydrochloride

15 Oct 2026

·www.biospace.com

Xeris Biopharma Reinforces Leadership in Endocrinology With Data Disclosures Spanning Commercial Portfolio and Pipeline at Multiple Scientific Meetings

Clinical and scientific data presentations in support of Gvoke® (glucagon) injection, Recorlev® (levoketoconazole), and the investigational XP-8121 program underscore Xeris's leadership in endocrinology, including the treatments for Severe Hypoglycemia, Cushing's Syndrome, and Hypothyroidism CHICAGO--(BUSINESS WIRE)--Xeris Biopharma Holdings, Inc. (Nasdaq: XERS), a leading, endocrine and rare disease biopharmaceutical company committed to helping people realize better lives through the development and commercialization of innovative medicines, today announced clinical and scientific data presentations from its commercial portfolio and development pipeline at three scientific meetings this fall: Breakthrough T1D Clinical & Research Congress (CRC), the 21st Annual Cardiometabolic Health Congress (CMHC), and the American Thyroid Association (ATA) Annual Meeting. “These presentations reflect the breadth and depth of our scientific work and collaborations across endocrinology, as well as our commitment to advancing care at every stage, from established therapies to emerging treatment approaches,” said Anh Nguyen, MD, Chief Medical Officer of Xeris Biopharma. “By sharing real-world experience with Recorlev and new research on Gvoke, we continue to build the evidence supporting therapies patients rely on today. At the same time, our TriNetX analysis expands our understanding of real-world biochemical control among patients with hypothyroidism treated with oral levothyroxine.” Presentation Highlights Severe Hypoglycemia – Gvoke at the 2026 Breakthrough T1D Clinical & Research Congress New real-world data examines the gap between HCP awareness of American Diabetes Association standard of care treatment guidelines for prescribing ready-to-use glucagon, when compared to actual prescribing practices. Data underscores the unmet clinical unmet need and ongoing opportunity to increase adoption of ready-to-use glucagon products. Hypercortisolism in Cushing’s Syndrome and associated cardiometabolic comorbidities – Recorlev at the 2026 Cardiometabolic Health Congress A compelling case study demonstrates normalization of cortisol following treatment with levoketoconazole, accompanied by meaningful improvements in multiple cardiometabolic parameters, in a patient with uncontrolled Type 2 diabetes, hypertension, and multiple comorbidities. This case study highlights the important role of cortisol normalization in cardiometabolic health. Hypothyroidism – Characterization of a real-world hypothyroid population using linked levothyroxine treatment and TSH data at the 2026 American Thyroid Association Annual Meeting First public presentation of a real-world analysis using linked levothyroxine treatment records and TSH laboratory data to characterize patients with hypothyroidism and explore approaches for longitudinal assessment. Presentation Details Breakthrough T1D Clinical & Research Congress (CRC 2026): October 9–10, 2026, Philadelphia, PA Abstract title : Ensuring Readiness: A Case For Proactive Glucagon Prescribing For Patients At Increased Risk of Severe Hypoglycemia Presenter : Natasha Ferguson, PhD (Xeris Biopharma) Presentation : Friday, October 9, 2026 (already presented) Annual Cardiometabolic Health Congress (CMHC 2026): October 15–16, 2026, Boston, MA Abstract title : Discontinuation of Antihypertensives and Insulin in a Patient with Difficult-to-Control Type 2 Diabetes and Hypertension After Treatment With Levoketoconazole Presenter : Lee Wesler, MD, FACP (Day Kimball Medical Group) Presentation : Thursday, October 15, 2026, 10:45 a.m. EST, and Friday, October 16, 2026, 6:15 p.m. EST American Thyroid Association (ATA 2026) Annual Meeting: November 4–7, 2026, Philadelphia, PA Abstract title : Characterization of a Real-World Hypothyroid Population Using Linked Levothyroxine Treatment and TSH Data: A TriNetX Analysis Presenter : James M. Meyer, PharmD, MBA (Xeris Biopharma) Presentation : Friday, November 6, 2026, 10:00 a.m. EST ABOUT RECORLEV ® Indication RECORLEV (levoketoconazole) is a cortisol synthesis inhibitor indicated for the treatment of endogenous hypercortisolemia in adult patients with Cushing’s syndrome for whom surgery is not an option or has not been curative. Limitations of use: RECORLEV is not approved for the treatment of fungal infections. Important Safety Information WARNING: HEPATOTOXICITY AND QT PROLONGATION Cases of hepatotoxicity with fatal outcome or requiring liver transplantation have been reported with oral ketoconazole. Some patients had no obvious risk factors for liver disease. RECORLEV is associated with serious hepatotoxicity. Evaluate liver enzymes prior to and during treatment. RECORLEV is associated with dose-related QT interval prolongation. QT interval prolongation may result in life-threatening ventricular dysrhythmias such as torsades de pointes. Perform ECG and correct hypokalemia and hypomagnesemia prior to and during treatment. RECORLEV is contraindicated in patients: With cirrhosis, acute liver disease or poorly controlled chronic liver disease, baseline AST or ALT >3 times the upper limit of normal, recurrent symptomatic cholelithiasis, a prior history of drug-induced liver injury due to ketoconazole or any azole antifungal therapy that required discontinuation of treatment, or extensive metastatic liver disease Taking drugs that cause QT prolongation associated with ventricular arrhythmias, including torsades de pointes With prolonged QTcF interval >470 msec at baseline, history of torsades de pointes, ventricular tachycardia, ventricular fibrillation, or long QT syndrome With hypersensitivity to levoketoconazole, ketoconazole, or any excipient in RECORLEV Taking certain drugs that are sensitive substrates of CYP3A4 or CYP3A4 and P-gp RECORLEV may lead to hypocortisolism with a potential for life-threatening adrenal insufficiency. Dosage reduction or interruption may be necessary Hypersensitivity to RECORLEV has been reported. Anaphylaxis has been reported with oral ketoconazole RECORLEV may lower serum testosterone in men and women. Inform patients to report associated symptoms Most common adverse reactions are nausea/vomiting, hypokalemia, hemorrhage/contusion, systemic hypertension, headache, hepatic injury, abnormal uterine bleeding, erythema, fatigue, abdominal pain/dyspepsia, arthritis, upper respiratory infection, myalgia, arrhythmia, back pain, insomnia/sleep disturbances, and peripheral edema Avoid use of strong CYP3A4 inhibitors and inducers 2 weeks before and during RECORLEV treatment. Consult approved product labeling for drugs that are substrates of CYP3A4, P-gp, OCT2, and MATE prior to initiating RECORLEV. For atorvastatin, metformin, and gastric acid modulators, see full Prescribing Information for recommendations regarding concomitant use with RECORLEV Breastfeeding is not recommended during treatment and for one day after final dose Please see full Prescribing Information , including Boxed Warning, for RECORLEV. ABOUT GVOKE ® Indication GVOKE (glucagon) is an antihypoglycemic agent indicated for subcutaneous use for the treatment of severe hypoglycemia in adult and pediatric patients aged 2 years and older with diabetes. Important Safety Information GVOKE is contraindicated in patients with: Pheochromocytoma because of the risk of substantial increase in blood pressure Insulinoma because of the risk of hypoglycemia Prior hypersensitivity reaction to glucagon or to any of the excipients. Serious hypersensitivity reactions have been reported with glucagon, including generalized rash, and anaphylactic shock with breathing difficulties and hypotension GVOKE may stimulate the release of catecholamines from the tumor. If patient develops a substantial increase in blood pressure and a previously undiagnosed pheochromocytoma is suspected, 5 to 10 mg of phentolamine mesylate intravenously has been shown to be effective in lowering blood pressure In patients with insulinoma, administration of glucagon may produce an initial increase in blood glucose; however, administration may stimulate exaggerated insulin release from an insulinoma and cause hypoglycemia. If a patient develops symptoms of hypoglycemia after a dose of GVOKE, give glucose orally or intravenously Patients with insufficient hepatic stores of glycogen may not respond to GVOKE for treatment of severe hypoglycemia. Insufficient hepatic stores of glycogen may be present in conditions such as states of starvation, or in patients with adrenal insufficiency or chronic hypoglycemia A skin rash called necrolytic migratory erythema (NME), has been reported post-marketing following continuous glucagon infusion and resolved with discontinuation of the glucagon. GVOKE is not approved for continuous infusion. Should NME occur, consider whether the benefits of continuous glucagon infusion outweigh the risks Most common adverse reactions reported in adult patients were nausea, vomiting, injection site edema raised 1 mm or greater, and headache Most common adverse reactions reported in pediatric patients were nausea, hypoglycemia, vomiting, headache, abdominal pain, hyperglycemia, injection site discomfort and reaction, and urticaria Patients taking concomitant beta-blockers may have a transient increase in pulse and blood pressure. In patients taking concomitant indomethacin, GVOKE may lose its ability to raise glucose or may produce hypoglycemia. GVOKE may increase the anticoagulant effect of warfarin Please see full Prescribing Information for GVOKE. About Xeris Biopharma Xeris Biopharma Holdings, Inc. (Nasdaq: XERS) is a leading endocrine and rare disease biopharmaceutical company committed to helping people realize better lives through the development and commercialization of innovative medicines for serious diseases with significant unmet medical need. Xeris has three commercially available products: Recorlev ® , a cortisol synthesis inhibitor for the treatment of endogenous Cushing’s syndrome; Gvoke ® , a ready-to-use liquid glucagon for the treatment of severe hypoglycemia; and Keveyis ® , a proven therapy for primary periodic paralysis. Xeris also has a pipeline of development programs led by XP-8121, a Phase 3-ready, once-weekly subcutaneous injection for the treatment of hypothyroidism, as well as multiple early-stage programs leveraging Xeris’ technology platforms, XeriSol ® and XeriJect ® , for Xeris and its partners. Xeris Biopharma Holdings is headquartered in Chicago, IL. For more information, please visit us at xerispharma.com and follow on X , LinkedIn , or Instagram . Forward-Looking Statements Any statements in this press release other than statements of historical fact are forward-looking statements. Forward-looking statements include, but are not limited to, statements about future expectations, plans, opportunities, and prospects for the Company, including statements, among other things, the market and therapeutic and commercial potential of its products and product candidates, the potential utility of its formulation platforms, the advancement of its pipeline the Company's plans regarding clinical developments, and other statements containing the words "achieve," "anticipate," “believe,” “continue,” “expect,” “potential,” “should,” “will,” “would,” and similar expressions, constitute forward-looking statements within the meaning of The Private Securities Litigation Reform Act of 1995. These forward-looking statements are based on numerous assumptions and assessments made in light of Xeris’ experience and perception of historical trends, current conditions, business strategies, operating environment, future developments, geopolitical factors, and other factors it believes appropriate. By their nature, forward-looking statements involve known and unknown risks and uncertainties because they relate to events and depend on circumstances that will occur in the future. The various factors that could cause Xeris’ actual results, performance or achievements, industry results, market opportunity and developments to differ materially from those expressed in or implied by such forward-looking statements , include, but are not limited to, its financial position and need for financing, including to fund its product development programs or commercialization efforts, whether its products will achieve and maintain market acceptance in a competitive business environment, its reliance on third-party suppliers, including single-source suppliers, its reliance on third parties to conduct clinical trials, the ability of its product candidates to compete successfully with existing and new drugs, its and collaborators’ ability to protect its intellectual property and proprietary technology, the accuracy and completeness of its assumptions and its ability to accurately estimate future financial results and market opportunities, and general macroeconomic and geopolitical conditions, including the possibility of an economic downturn, political unrest, trade disputes, changes in U.S. governmental priorities and resources, announced or implemented tariffs or export controls and market volatility. No assurance can be given that such expectations will be realized and persons reading this communication are, therefore, cautioned not to place undue reliance on these forward-looking statements. Additional risks and information about potential impacts of financial, operational, economic, competitive, regulatory, governmental, technological, and other factors that may affect Xeris can be found in Xeris’ filings, including its most recently filed Annual Report on Form 10-K and subsequent filings with the U.S. Securities and Exchange Commission, the contents of which are not incorporated by reference into, nor do they form part of, this communication. The risks described herein and in Xeris’ U.S. Securities and Exchange Commission filings are not the only risks the Company faces. Additional risks and uncertainties not currently known to it or that it currently deems immaterial may also impact its business operations or financial results. Forward-looking statements in this communication are based on information available to management, as of the date of this communication and, while the Company believes its assumptions are reasonable, actual results may differ materially. Subject to any obligations under applicable law, the Company does not undertake any obligation to update any forward-looking statement whether as a result of new information, future developments or otherwise, or to conform any forward-looking statement to actual results, future events, or to changes in expectations. US-GVK-26-00109 (v1) 10/26 Contacts Investor & Media Contact Cristi Barnett Vice President, Investor Relations ir@xerispharma.com

Phase 3Drug Approval

08 Oct 2026

·www.prnewswire.com

Dipeptidyl Peptidase-4 (DPP-4) Inhibitors Market to Reach USD 15,527.66 Million by 2032 - Credence Research

LONDON, Oct. 8, 2026 /PRNewswire/ -- The "Dipeptidyl Peptidase-4 (DPP-4) Inhibitors Market – Growth, Share, Opportunities & Competitive Analysis, 2026–2032" report has been added to the Credence Research Inc. offering. The global Dipeptidyl Peptidase-4 (DPP-4) Inhibitors Market was valued at USD 11,280.60 million in 2025 and is projected to reach USD 15,527.66 million by 2032, registering a CAGR of 5.47%. Demand is supported by the persistent global burden of type 2 diabetes, continued use of oral glucose-lowering therapies and the expanding availability of generics and fixed-dose combinations. DPP-4 inhibitors remain relevant for selected patients who benefit from simple oral dosing, low hypoglycemia risk and weight-neutral treatment profiles, although newer incretin and cardiometabolic therapies are increasing competitive pressure. Key Takeaways The market is projected to rise from USD 11,280.60 million in 2025 to USD 15,527.66 million by 2032 at a CAGR of 5.47%. Sitagliptin led the drug type segment with a 36.9% share in 2025, supported by long-standing prescribing familiarity, broad availability and generic participation. Retail pharmacies accounted for 44.8% of 2025 revenue, reflecting repeat-refill behavior in chronic outpatient diabetes management. North America led with a 37.8% share in 2025, followed by Europe at 26.1% and Asia Pacific at 23.4%. Fixed-dose combinations with metformin remain strategically important because they can reduce pill burden and support stepwise treatment intensification. Validated core participants include Merck & Co., AstraZeneca, Boehringer Ingelheim, Takeda Pharmaceutical, Novartis, Eli Lilly, Lupin, Sun Pharmaceutical and Dr. Reddy's Laboratories. Scope & Segmentation – Dipeptidyl Peptidase-4 (DPP-4) Inhibitors Market The report provides a comprehensive analysis of the global DPP-4 Inhibitors Market through 2032, covering drug molecules, formulation formats, treatment sequencing, combination strategies, dispensing channels and patient groups. The study evaluates how generic entry, payer formularies, fixed-dose combinations and competition from GLP-1, dual incretin and SGLT2 therapies are reshaping commercial strategies. It also examines regional access, chronic refill infrastructure and molecule-level considerations that influence prescribing. The DPP-4 Inhibitors Market is segmented based on drug type, formulation, therapy line, combination type, distribution channel, patient type and geography. By Drug Type, the market includes Sitagliptin, Saxagliptin, Linagliptin, Alogliptin and Others. By Formulation, the market includes Oral Tablets, Fixed-dose Combinations and Others. By Therapy Line, the market includes First-line Therapy, Second-line Therapy, Add-on Therapy and Others. By Combination Type, the market includes Monotherapy, Combination with Metformin, Combination with SGLT2 and Others. By Distribution Channel, the market includes Hospital Pharmacies, Retail Pharmacies, Online Pharmacies and Others. By Patient Type, the market includes Type 2 Diabetes Adults, Elderly Patients, Renal-impaired Patients and Others. By Geography, the market is analyzed across North America, Europe, Asia Pacific, Latin America and Middle East & Africa. Access crucial information at unmatched prices! Request your sample report today and start making informed decisions powered by Credence Research Inc. Why This Report Matters The report provides a focused view of a mature but resilient oral diabetes drug class undergoing a transition from branded growth toward access-led generic volume. It helps decision-makers assess molecule-level demand, fixed-dose combination opportunities, distribution dynamics and evolving therapy-line positioning. The study highlights the commercial impact of newer diabetes classes that offer weight-loss or broader cardiometabolic benefits. For pharmaceutical manufacturers, generic drug companies, distributors and investors, the report provides actionable intelligence for portfolio, pricing and market-access decisions. Market Overview • Industry Landscape and Value Chain Assessment • Supply-Side Evaluation • Demand-Side Evaluation • Stakeholder Mapping • Porter's Five Forces Review • PESTLE Environment Assessment • Market Forecast and Future Direction • Short-Term Forecast, 0–2 Years • Mid-Term Forecast, 3–5 Years • Long-Term Forecast, 5–10 Years • Market Entry and Expansion Strategy Market Insights • Patient and Prescriber Analysis • Therapy Sequencing Assessment • Generic Entry and Substitution Review • Fixed-Dose Combination Opportunity Assessment • Distribution and Refill Channel Review • Pricing and Reimbursement Analysis • Competitive Class Substitution Assessment • Regional Access and Diagnosis Review • Lifecycle Management and Portfolio Strategy Key Attributes Segmentation By Drug Type • Sitagliptin • Saxagliptin • Linagliptin • Alogliptin • Others By Formulation • Oral Tablets • Fixed-dose Combinations • Others By Therapy Line • First-line Therapy • Second-line Therapy • Add-on Therapy • Others By Combination Type • Monotherapy • Combination with Metformin • Combination with SGLT2 • Others By Distribution Channel • Hospital Pharmacies • Retail Pharmacies • Online Pharmacies • Others By Patient Type • Type 2 Diabetes Adults • Elderly Patients • Renal-impaired Patients • Others By Geography • North America • Europe • Asia Pacific • Latin America • Middle East & Africa Market Growth Driven by Chronic Type 2 Diabetes Demand and Oral Therapy Preference The persistent global burden of type 2 diabetes supports recurring demand for oral glucose-lowering medicines. DPP-4 inhibitors retain a role in selected patients because they offer simple daily administration, a generally low risk of hypoglycemia and a weight-neutral profile. These characteristics can be valuable in older patients, people managing multiple medicines and treatment plans where tolerability is prioritized. Generic entry is changing the revenue mix. Loss of exclusivity has reduced branded pricing power in several markets, yet lower-cost sitagliptin and other molecules can expand access and preserve prescription volume. Wider retail pharmacy availability and e-pharmacy distribution also support continuity for chronic therapy users. Fixed-dose combinations remain an important lifecycle strategy. Pairing DPP-4 inhibitors with metformin or other oral agents can simplify regimens and support patients who require stepwise treatment intensification without moving immediately to injectable therapy. Competitive Pressure from Newer Diabetes Therapies Reshapes the Market DPP-4 inhibitors face stronger competition from GLP-1 receptor agonists, dual incretin therapies and SGLT2 inhibitors. These newer classes can offer weight reduction or broader cardiovascular and renal benefits in selected patient populations, which can influence guideline positioning and payer preference. This pressure makes affordability, tolerability, oral convenience and combination availability increasingly important sources of differentiation. Manufacturers must manage mature brands carefully while generic suppliers compete on price, supply reliability and pharmacy coverage. Regional Growth Reflects Reimbursement Depth and Expanding Access North America led the market with a 37.8% share in 2025, supported by established diagnosis pathways, structured reimbursement and a mature retail refill infrastructure. Europe accounted for 26.1%, where reference pricing and cost-containment policies accelerate generic uptake while preserving steady outpatient use. Asia Pacific represented 23.4% of the market and offers substantial volume potential due to large diabetes populations, improving diagnosis and expanding pharmacy access. Latin America and Middle East & Africa remain smaller in revenue terms, with growth dependent on affordability, distributor reach and reimbursement development. Future Outlook The DPP-4 inhibitor market is expected to expand steadily rather than rapidly through 2032. Growth will be supported by chronic disease prevalence, generic access and fixed-dose combinations, while class share will remain under pressure from newer therapies with stronger weight and cardiometabolic profiles. Companies with broad generic portfolios, strong local distribution and combination-product capabilities will be better positioned to defend volume. Market opportunities will increasingly center on affordability, emerging-market access and simplified regimens rather than premium pricing. Competitive Landscape Competition is shifting from brand exclusivity toward formulary placement, generic substitution, combination availability and supply reliability. Merck remains closely associated with sitagliptin, while AstraZeneca, Boehringer Ingelheim, Takeda and Novartis have established DPP-4 portfolios or legacy brands. Eli Lilly remains relevant through its long-standing collaboration with Boehringer Ingelheim around linagliptin. Generic manufacturers including Lupin, Sun Pharmaceutical and Dr. Reddy's Laboratories strengthen price competition and expand access in large emerging markets. The strongest commercial positions increasingly depend on distribution coverage, procurement competitiveness and the ability to sustain reliable supply after patent expiry. Key Player Analysis • Merck & Co. • AstraZeneca • Boehringer Ingelheim • Takeda Pharmaceutical • Novartis • Eli Lilly and Company • Lupin • Sun Pharmaceutical • Dr. Reddy's Laboratories Recent Industry Developments In June 2025, Abbott and MSD Pharmaceuticals announced a distribution agreement in India covering sitagliptin, sitagliptin/metformin and the extended-release combination, expanding access to MSD's established DPP-4 portfolio. In January 2025, CSPC Pharmaceutical Group announced that China's National Medical Products Administration granted marketing approval for prusogliptin tablets, a new DPP-4 inhibitor for adults with type 2 diabetes. Report Coverage The research report offers an in-depth analysis based on Drug Type, Formulation, Therapy Line, Combination Type, Distribution Channel, Patient Type and Geography. It assesses market size, regional demand, competitive positioning, generic entry, fixed-dose combinations, reimbursement dynamics and the impact of alternative diabetes drug classes. The study provides strategic recommendations for branded manufacturers, generic companies, distributors and investors navigating a mature therapeutic category with changing treatment preferences. Access crucial information at unmatched prices! Request your sample report today and start making informed decisions powered by Credence Research Inc. Shape Your Report to Specific Countries or Regions and Enjoy 30% Off! Customize Now Related Reports – About Us Credence Research Inc is a global market intelligence and consulting firm founded in 2015. It delivers deep market insights, quantitative analysis, and strategic guidance to business leaders, investors, governments, NGOs, and non-profit groups worldwide. The company helps organizations evaluate markets, understand trends, reduce risk, and make data-driven decisions that support growth and competitive strategy. Credence Research is known for rigorous research methods and comprehensive analytics. The firm produces detailed reports covering market size, forecasts, growth drivers, trends, and competitive landscapes across many industries. Each report often includes frameworks like PESTLE and Porter's Five Forces to give a complete view of market dynamics and future potential. Credence Research also provides tailored consulting services, due diligence support, go-to-market planning, and pre-IPO research to strengthen client strategies and investment narratives. Its insights come from both primary and secondary research, expert interviews, and advanced data modelling. The firm's client base spans Europe, the Americas, Asia-Pacific, and the Middle East/Africa. 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Drug Approval

07 Oct 2026

·www.biospace.com

Zealand Pharma announces positive Phase 2 ZUPREME-2 topline results for amylin analog petrelintide in people with overweight or obesity and type 2 diabetes

Company announcement – No. 54 / 2026 Zealand Pharma announces positive Phase 2 ZUPREME-2 topline results for amylin analog petrelintide in people with overweight or obesity and type 2 diabetes Petrelintide achieved up to 9.2% mean body weight reduction at week 28 versus 2.0% with placebo At week 28, petrelintide demonstrated a HbA1c reduction of up to 0.65% versus an increase of 0.23% with placebo Safety and tolerability pro petrelintide was consistent with that seen in the Phase 2 ZUPREME-1 trial Very low discontinuation rates due to gastrointestinal adverse events (1.9% for petrelintide versus 1.7% in placebo group) Data reinforce potential of petrelintide as a future first choice therapy for chronic weight management Copenhagen, Denmark, October 7, 2026 – Zealand Pharma A/S (Nasdaq: ZEAL) (CVR-no. 20045078), a biotechnology company transforming the future of metabolic health, today announced positive topline results from the Phase 2 ZUPREME-2 trial evaluating the efficacy and safety of petrelintide versus placebo in 220 people living with overweight or obesity and type 2 diabetes (mean baseline BMI of 36.3 kg/m 2 ; mean baseline HbA1c of 8.0%). The trial met its primary endpoint, demonstrating that once-weekly subcutaneous injections of petrelintide (escalated every fourth week) resulted in statistically significant and clinically meaningful reductions in body weight from baseline after 28 weeks in all three treatment arms compared to placebo. Study participants achieved up to 9.2% mean weight loss from baseline using the efficacy estimand (range across treatment arms: 7.4-9.2%), compared to 2.0% with placebo, with results remaining largely consistent under the treatment regimen estimand. Petrelintide also demonstrated clinically relevant reduction in HbA1c across all treatment arms with participants achieving a placebo-adjusted HbA1c reduction of 0.61%-0.88%. “These results further support the potential of petrelintide in chronic weight management and, for the first time, demonstrate its promise as a standalone treatment for those living with overweight or obesity and type 2 diabetes,” said David Kendall, MD, Chief Medical Officer at Zealand Pharma. “These data confirm the potential for clinically meaningful weight reduction with a promising and favorable tolerability profile. We are also encouraged by the improvements in glycemic control - a combination essential for supporting long-term, sustained benefits in people living with obesity and type 2 diabetes. Together with Roche, we look forward to investigating petrelintide in our recently initiated Phase 3 registrational program to address important unmet medical needs in chronic weight management.” No unexpected safety signals were observed with petrelintide treatment. Petrelintide demonstrated a favorable tolerability pro comparable to placebo. The treatment discontinuation rate due to gastrointestinal adverse events (AEs) was 1.9% for participants treated with petrelintide versus 1.7% with placebo. The most frequently reported AEs were gastrointestinal-related, the vast majority of which were mild and occurred during the escalation period. The safety and tolerability pro petrelintide observed in ZUPREME-2 confirms the findings of the 42-week Phase 2 ZUPREME-1 trial in people with overweight or obesity without type 2 diabetes. The full trial results from ZUPREME-2 are expected to be presented at an upcoming scientific conference. Zealand Pharma and Roche have started a Phase 3a program for petrelintide which consists of three trials: ZUPREME-3, ZUPREME-4, and ZUPREME-5, evaluating the efficacy and safety of once-weekly petrelintide versus placebo in people with obesity or overweight without type 2 diabetes, people with obesity or overweight with type 2 diabetes, and people with obesity or overweight and established cardiovascular disease, respectively. The three trials are expected to enroll approximately 7,000 participants in total and the first individuals have initiated treatment. For more information about the Phase 3 program, refer to Zealand Pharma Press Release no. 17 / 2026. This company announcement discloses inside information pursuant to Article 17 of the Market Abuse Regulation (EU) No 596/2014. About ZUPREME-2 ZUPREME-2 was a randomized, double-blind, placebo-controlled, parallel-group, multicenter, US-based Phase 2b clinical trial (NCT06926842). The trial compared three doses of once-weekly petrelintide with placebo, when added to a reduced-calorie diet and increased physical activity in participants with overweight or obesity and type 2 diabetes on metformin with or without an SGLT2 inhibitor. The trial included a screening period, a dose escalation treatment period up to 16 weeks with dose escalation every fourth week followed by a maintenance treatment period until week 28, and a follow-up period after treatment was completed until week 38. ZUPREME-2 enrolled a total of 220 participants in the United States. The primary endpoint in the trial is the percentage change in body weight from baseline to week 28. Secondary endpoints include, but are not limited to, body weight loss of ≥5% and ≥10%, absolute change in body weight, change in waist circumference, change in hemoglobin A1c (HbA1c), change in high-sensitivity C-reactive protein (hsCRP), change in fasting glucose, and change in fasting lipids. For more information about the ZUPREME-2 clinical trial of petrelintide, please visit . About petrelintide Petrelintide is a long-acting human amylin analog suitable for once-weekly subcutaneous administration that has been designed with chemical and physical stability with no fibrillation around neutral pH, allowing for co-formulation and co-administration with other peptides 1 . The hormone amylin is produced in the pancreatic beta cells and co-secreted with insulin in response to ingested nutrients. Amylin receptor activation has been shown to reduce body weight by restoring sensitivity to the satiety hormone leptin 2,3 , inducing a sense of feeling full faster. In 2025, Zealand Pharma and Roche entered into an exclusive collaboration and licensing agreement to co-develop and co-commercialize petrelintide for people living with overweight and obesity. Petrelintide is currently being developed for chronic weight management as both a monotherapy agent and in combination with Roche’s GLP-1/GIP receptor dual agonist enicepatide (CT-388). A Phase 2 trial evaluating the combination of petrelintide and enicepatide (CT-388) is planned for initiation in the second half of 2026. About Zealand Pharma A/S Zealand Pharma A/S (Nasdaq: ZEAL) is a biotechnology company focused on advancing medicines for obesity and metabolic health. Combining more than 25 years of peptide R&D expertise with a proprietary data platform that leverages advanced data‑driven and AI/ML approaches, Zealand Pharma aims to lead a new era in obesity and metabolic health. To date, more than ten Zealand Pharma‑invented drug candidates have entered clinical development, of which two products have reached the market and three candidates are in late-stage development. The Company has collaborations with global pharmaceutical and biotechnology partners for research, development, and commercialization. Founded in 1998, Zealand Pharma is headquartered in Copenhagen, Denmark, with a U.S. presence in Cambridge, Massachusetts. Learn more at . Forward-looking statements This company announcement contains “forward-looking statements”, as that term is defined in the Private Securities Litigation Reform Act of 1995 in the United States, as amended, even though no longer listed in the United States this is used as a definition to provide Zealand Pharma’s expectations or forecasts of future events regarding the research, development, and commercialization of pharmaceutical products, the timing of the company’s clinical trials and the reporting of data therefrom and the company’s significant events and potential catalysts in 2026 and financial guidance for 2026. These forward-looking statements may be identified by words such as “aim,” “anticipate,” “believe,” “could,” “estimate,” “expect,” “forecast,” “goal,” “intend,” “may,” “plan,” “possible,” “potential,” “will,” “would”, and other words and terms of similar meaning. You should not place undue reliance on these statements, or the scientific data presented. The reader is cautioned not to rely on these forward-looking statements. Such forward-looking statements are subject to risks, uncertainties and inaccurate assumptions, which may cause actual results to differ materially from expectations set forth herein and may cause any or all of such forward-looking statements to be incorrect, and which include, but are not limited to, unexpected costs or delays in clinical trials and other development activities due to adverse safety events or otherwise; unexpected concerns that may arise from additional data, analysis or results obtained during clinical trials; our ability to successfully market both new and existing products; changes in reimbursement rules and governmental laws and related interpretation thereof; government-mandated or market-driven price decreases for our products; introduction of competing products; production problems; unexpected growth in costs and expenses; our ability to effect the strategic reorganization of our businesses in the manner planned; failure to protect and enforce our data, intellectual property and other proprietary rights and uncertainties relating to intellectual property claims and challenges; regulatory authorities may require additional information or further studies, or may reject, fail to approve or may delay approval of our drug candidates or expansion of product labelling; failure to obtain regulatory approvals in other jurisdictions; exposure to product liability and other claims; interest rate and currency exchange rate fluctuations; unexpected contract breaches or terminations; inflationary pressures on the global economy; and political uncertainty. If any or all of such forward-looking statements prove to be incorrect, our actual results could differ materially and adversely from those anticipated or implied by such statements. The foregoing sets forth many, but not all, of the factors that could cause actual results to differ from our expectations in any forward-looking statement. All such forward-looking statements speak only as of the date of this press release/company announcement and are based on information available to Zealand Pharma as of the date of this release/announcement. We do not undertake to update any of these forward-looking statements to reflect events or circumstances that occur after the date hereof. Information concerning pharmaceuticals (including compounds under development) contained within this material is not intended as advertising or medical advice. Zealand Pharma® is a registered trademark of Zealand Pharma A/S. Contacts Eric Rojas (Investors) Vice President, Head of Investor Relations erojas@zealandpharma.com Neshat Anis Ahmadi (Investors) Manager, Investor Relations neahmadi@zealandpharma.com Rachel James-Owens (Media) Vice President, Corporate Communications & Media Relations Email: RJamesOwens@zealandpharma.com Andreas Hylleberg (Media) Director, External Communications Email: AHylleberg@zealandpharma.com Amber Fennell, Jessica Hodgson, Sean Leous (Media) ICR Healthcare Email: ZealandPharma@icrhealthcare.com +44 (0) 7739 658 783 Sources 1. Eriksson et al. Presentation at ObesityWeek, November 1–4, 2022, San Diego, CA. Link: . 2. Mathiesen et al. Eur J Endocrinol 2022;186(6):R93–R111. 3. Roth et al. Proc Natl Acad Sci U S A 2008;105(20):7257–7262. Attachment Zealand Pharma announces positive Phase 2 ZUPREME-2 topline results for amylin analog petrelintide in people with overweight or obesity and type 2 diabetes

Phase 2Clinical ResultLicense out/inPhase 3

100 Deals associated with Metformin Hydrochloride

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KEGG	Wiki	ATC	Drug Bank
D00944	Metformin Hydrochloride	A10BA02	DBSALT000114

R&D Status

Approved

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Indication	Country/Location	Organization	Date
Diabetes Mellitus	United States	Andrx Labs LLC	27 Apr 2004
Diabetes Mellitus, Type 2	China	Ankang Zhengda Pharmaceutical Co. Ltd.	01 Jan 1992

Developing

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Indication	Highest Phase	Country/Location	Organization	Date
Invasive Mammary Carcinoma	Phase 3	United States	City of Hope National Medical Center	13 Jan 2025
Chronic Disease	Phase 3	United States	Oklahoma Medical Research Foundation	29 Jul 2020
Acquired Immunodeficiency Syndrome	Phase 3	United States	Merck Sharp & Dohme Corp.	01 Feb 2019
Aortic Aneurysm, Abdominal	Phase 3	Austria	Merck Healthcare Germany GmbH	26 Sep 2018
Fragile X Syndrome	Phase 3	United States	University of California, Davis	30 Apr 2018
Fragile X Syndrome	Phase 3	Canada	University of California, Davis	30 Apr 2018
Metabolic Syndrome	Phase 3	United States	Rutgers State University of New Jersey	07 Aug 2017
Atypical hyperplasia	Phase 3	United States	Alliance Foundation Trials LLC	23 Nov 2015
Breast Ductal Carcinoma	Phase 3	United States	Alliance Foundation Trials LLC	23 Nov 2015
Noninfiltrating Intraductal Carcinoma	Phase 3	United States	Alliance Foundation Trials LLC	23 Nov 2015

Clinical Result

Indication

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Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT04196868 (ACR2026)	Phase 2	Rheumatoid Arthritis	126	Methotrexate + Metformin	jjgjeoegqa(qgswczkqqu) = yupjjvcsme gozamghhtd (jpolmdetwh ) View more	Negative	06 Nov 2026
				Methotrexate + Placebo	jjgjeoegqa(qgswczkqqu) = odnqfvoqlm gozamghhtd (jpolmdetwh ) View more
NCT06128967 (Pubmed \| Ann Intern Med)	Phase 3	Post Acute COVID 19 Syndrome	399	Fluvoxamine	bmtsqrfbcy(epoxjltmrc) = fectrdvkwp zgbesztxxt (vrjazwnfva ) View more	Positive	06 Oct 2026
				Metformin 750 mg BID	bmtsqrfbcy(iiapvfcsgf) = qfhqyfanwo strkcewchy (ghujfdkegj )
NCT04625946 (CTgov)	Phase 4	Atrial Fibrillation	117	Recommendations for lifestyle modification.+Metformin (Metformin)	xyozmqwjxj = fjvbdthunl qksdmmqobb (hdzydndgap, uxwcjxchxi - owoowdwvgu) View more	-	06 Oct 2026
				Recommendations for lifestyle modification. (Standard of Care)	xyozmqwjxj = yujhucfpgl qksdmmqobb (hdzydndgap, qklghdudwo - jcubbpbghp) View more
EASD2026	Not Applicable	Diabetes Mellitus, Type 2	91,269	Metformin	fjdqdsxyjo(yozelwsprw) = dirhwyvmuk yuovtkqbog (kwzfpwonsm, 1.3) View more	Negative	28 Sep 2026
				Dipeptidyl peptidase 4 inhibitors	fjdqdsxyjo(yozelwsprw) = firtxgrfdo yuovtkqbog (kwzfpwonsm, 1.3) View more
NCT04221750 (DEMFOS, CTgov)	Phase 3	Obesity \| Frailty Syndrome	114	Lifestyle therapy+Metformin Hydrochloride (Lifestyle Therapy Plus Metformin)	banoexuhjo(ogagujsbbj) = eyhuesuxys ydzsptwuln (tnzdsbwcme, 0.4) View more	-	14 Sep 2026
				Lifestyle therapy (Lifestyle Therapy Plus Placebo)	banoexuhjo(ogagujsbbj) = guwjfnodwh ydzsptwuln (tnzdsbwcme, 0.4) View more
NCT05237960 (CTgov)	Phase 2	Oral Leukoplakia \| Erythroplasia	34	Biopsy+Extended Release Metformin Hydrochloride (Arm I (Extended Release Metformin))	wgypukxjyl: P-Value = 0.715 View more	-	02 Sep 2026
				Biopsy (Arm II (Placebo))
NCT03054519 (PERMET, CTgov)	Phase 3	Peripheral Arterial Disease	202	Metformin (Metformin)	ejodfybjsa(ztpulagxyx) = irozkpwxlp ozmtsfvrnv (ampwwcskwi, 11.42) View more	-	24 Aug 2026
				Placebo (Placebo)	ejodfybjsa(ztpulagxyx) = hdytvheyfe ozmtsfvrnv (ampwwcskwi, 10.29) View more
NCT06728982 (Pubmed \| J Pharmacol Exp Ther)	Phase 2	Rectal Cancer Neoadjuvant	85	standard nCRT-radiotherapy 50.4 Gy in 28 daily fractions with concurrent oral capecitabine 825 mg2 twice daily	hkkafbcnxz(kykqiqzffb) = ghrwxtjgid yqsjpuhgtb (lecurihkkh ) View more	Positive	01 Aug 2026
				the same regimen plus oral metformin 1000 mg twice daily	hkkafbcnxz(kykqiqzffb) = wzsjcpfjwb yqsjpuhgtb (lecurihkkh ) View more
NCT01750567 (CTgov)	Phase 2	Recurrent Chronic Lymphoid Leukemia	37	Metformin	ayivavjupf(pwhssxvxyg) = yjcfhhjtsc szuomlrjou (qnymyzyfdm, gqwhrjabiy - ckcftjjwxd) View more	-	20 Jul 2026
NCT01101438 (CCTG MA.32, Pubmed \| JNCI Cancer Spectr)	Phase 3	Breast Cancer Adjuvant HER2 positive \| ER/PgR positive \| ER ... View more	3,649	Metformin	siniewqzqx(qozlyqrkuv) = bqutgkuils hoarynmmcd (mvuwexgyiu ) View more	Negative	07 Jul 2026
				Placebo	xtocoqungx(xyvqbjfkzn) = qaqeqqpjuk shwpmpfwtv (tbmssubpgt )

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