A groundbreaking clinical trial in the UK is investigating whether a widely available and inexpensive diabetes medication could stop the progression of a life-threatening vascular condition. Scientists are assessing the potential of metformin to be repurposed for treating abdominal aortic aneurysms (AAA).
First UK Patient Enrolled in Landmark Study
The UK arm of this international trial has enrolled its first participant, 80-year-old farmer Philip Gosling from Leicestershire. Mr Gosling was referred to a specialist after a routine screening detected a small AAA. With his aneurysm measuring 4cm—too small for surgical intervention—he was offered a place on the new research project.
"I'm glad to be on the trial," Mr Gosling stated. "I believe in research, I see the results of it every day on the farm... When they told me about the trial I had to get involved." The condition has forced him to stop lifting heavy objects on the family farm, a task he still helps his son with.
The Silent Threat of Aortic Aneurysms
An abdominal aortic aneurysm is a dangerous swelling in the body's main blood vessel, the aorta. While often presenting no symptoms, a rupture can be catastrophic. These aneurysms are responsible for an estimated 4,000 deaths each year in the UK. Currently, men over 64 are offered screening, as they are at highest risk.
For patients like Mr Gosling with a small AAA, standard care involves "watchful waiting" with regular scans to monitor growth. Once an aneurysm expands to a certain size, the risk of rupture increases significantly, and major surgery is required. This operation carries substantial risks, highlighting the urgent need for effective drug treatments to slow or halt growth.
A £1.2 Million Quest for a New Treatment
The trial, backed by a £1.2 million grant from the British Heart Foundation (BHF), is the largest ever drug trial for AAA. It aims to recruit 1,000 patients over two years across the UK, Australia, and New Zealand. Participants with a small AAA will be given either metformin or a placebo daily until their aneurysm requires surgical repair, a period expected to be at least two years.
Professor Matt Bown, BHF professor of vascular surgery at the University of Leicester, is leading the UK branch. He explained: "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 enlargement."
Professor Bryan Williams, chief scientific and medical officer at the BHF, emphasised the trial's importance: "To date we don't have effective drug treatments to limit the expansion of these aneurysms... 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."
Mr Gosling, who began the trial in July 2025 with a dose-tolerance phase, is now in the main study stage, receiving either the drug or a placebo. He remains optimistic: "My condition is very closely monitored, which can only be a good thing. Hopefully it will help a lot of people like me in the future."
