Original Investigation

Metformin to Improve Walking Performance in Lower Extremity Peripheral Artery Disease

JAMA 10.1001/jama.2025.21358

November 08, 2025 at 10:55 AM EST

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In people with lower extremity peripheral artery disease (PAD) who do not have diabetes, does metformin improve walking ability compared with placebo?In this double-blind randomized clinical trial of 202 participants with PAD and without diabetes randomized to metformin or placebo for 6 months, change in 6-minute walk distance at 6-month follow-up was not significantly different between participants randomized to metformin and those randomized to placebo (metformin: −5.4 m; placebo: −5.3 m).These results do not support metformin for improving walking performance in people with PAD.

Corresponding Author: Mary M. McDermott, MD, Northwestern University Feinberg School of Medicine, 750 N Rubloff, Tenth Floor, Chicago, IL 60611 (mdm608@northwestern.edu).

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