Investigation of the Efficacy of Metformin Therapy on Pulmonary Sarcoidosis

Exclusion Criteria

• •1. Inability to obtain consent
• •2. Age less than 18 years of age
• •3. Female participants of childbearing potential not willing use one of the following methods of birth control for the duration of the study and 90 days after study completion: condoms, sponge, foams, jellies, diaphragm, or non-hormonal intrauterine device, a vasectomized sole partner or abstinence. Females of childbearing potential must have a negative urine pregnancy test at screening visit
• •4. FVC predicted value is \< 45%.
• •5. Creatine clearance of \<30%.
• •6. History of idiopathic Lactate ≥ 2.2 mmol/L or acidosis on study baseline metabolic profile
• •7. End-stage fibrotic pulmonary disease
• •8. Significant underlying liver disease
• •9. Allergy or intolerance to metformin
• •10. Allergy or intolerance to albuterol
• •11. Poor venous access for obtaining blood samples
• •12. Significant disorder, other than sarcoidosis, that would complicate the treatment evaluation, such as respiratory, cardiac, renal, neurologic, musculoskeletal or seizure disorders.
• •13. Use of an investigational drug within 30 days prior to screening or within 5 half-lives of the agent, whichever is longer.
• •14. Currently receiving \>40mg prednisone.
• •15. ALT or AST ≥5 times upper limit of normal (ULN).
• •16. Leukopenia, as defined by WBC \<3.0 cells/mm3 or absolute neutrophil count \<1000 mm3
• •17. Breast feeding.
• •18. If patient is on immunomodulators, they must be on regimen for ≥3-month period and on a stable dose for ≥ 4 weeks.
• •19. Most recent nuclear medicine scan or echocardiogram (if done), demonstrating cardiac ejection fraction \<35%
• •20. Participant has persistent or active infections requiring hospitalization or treatment with antibiotics, antiretrovirals, or antifungals within 30 days of baseline. Minocycline and doxycycline are not considered antibiotics when used to treat sarcoidosis.
• •21. Any significant finding in the patient's medical history or physical or psychiatric exam prior to or after randomization that, in the opinion of the investigator, would affect patient safety or compliance or ability to deliver the study drug according to protocol.
• •22. On medications that, in the opinion of the investigator, would affect patient safety when taken with metformin
• •23. History of or receiving treatment for pulmonary hypertension. Receiving biologic medication within the 6 months prior to screening visit.