{
  "abstract": "Introduction Chronic obstructive pulmonary disease (COPD) is increasingly recognized as a disease of accelerated biological aging characterized by progressive lung function decline, emphysema progression and multiple age-related comorbidities. Current therapies improve symptoms and reduce exacerbations but have limited effects on disease progression. Metformin has demonstrated anti-aging properties through modulation of pathways involved in oxidative stress, inflammation, mitochondrial dysfunction and cellular senescence, making it a potential disease-modifying treatment in COPD.Methods AMICO (A Trial of Metformin In COPD) is an investigator-initiated, multicenter, randomized, double-blind, placebo-controlled phase III trial conducted in anonymous. A total of 212 patients with clinically stable COPD, centrilobular emphysema on computed tomography, post-bronchodilator FEV1 40%–70% predicted and accelerated FEV1 decline (>40 mL·year−1) will be randomized (1:1) to receive metformin (850 mg twice daily) or matching placebo for 36 months in addition to standard COPD treatment. Assessments include pulmonary function, chest computed tomography, exercise capacity, health status, muscle strength, body composition, age associated comorbidities development and aging-related biomarkers.The primary endpoint is the annual rate of FEV1 decline over 36 months. Secondary endpoints include emphysema progression, changes in diffusing capacity, COPD Assessment Test score, 6-minute walk distance, BODE index, handgrip strength, exacerbations, major cardiovascular events, cancer incidence and renal dysfunction.Conclusions AMICO is the first randomized trial specifically designed to evaluate metformin as a gerotherapeutic and disease-modifying intervention in COPD. The study may provide novel evidence supporting geroscience-based approaches to slow disease progression and improve long-term outcomes in patients with COPD.",
  "abstract_shown": true,
  "affiliations": [
    "Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain",
    "Pulmonary Department–Research Unit, Hospital Universitario Nuestra Señora de La Candelaria, CIBERES, ISCIII, Universidad de La Laguna, Tenerife, Spain",
    "Pulmonary Department, Hospital Universitario Miguel Servet, IIS Aragón & CIBERES, University of Zaragoza, Zaragoza, Spain",
    "Pulmonary Department, Hospital Universitario Doctor Negrín, CIBERES, ISCII, Las Palmas, Spain",
    "Pulmonary Department, Hospital San Pedro Alcántara, Cáceres, Spain",
    "Pulmonary Department, Hospital Universitario de Navarra, Pamplona, Spain",
    "Pulmonary Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain",
    "Pulmonary Department, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria Islas Baleares (IdISBa), Mallorca, Spain",
    "Pulmonary Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain",
    "Pulmonary Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain",
    "Group of Translational Research in Respiratory Medicine, IRB Lleida, Hospital Universitari Arnau de Vilanova i Santa Maria, CIBERES, ISCIII Lleida, Spain",
    "Pulmonary Department, Hospital Universitario San Pedro, Logroño, Spain",
    "Pulmonary Department, Hospital Universitario Ramón y Cajal, Madrid, Spain",
    "Pulmonary Department, Hospital Universitario La Paz, Madrid, Spain",
    "Pulmonary Department, Pulmonary Department, Hospital Clínico Universitario de Valencia, Valencia, Spain",
    "Pulmonary Department, Hospital Universitario Son Llatzer, Mallorca, Spain",
    "Pulmonary Department, Hospital Universitario de la Princesa, CIBERES, ISCIII, Madrid, Spain",
    "Radiology Department, Clínica Universidad de Navarra, Pamplona, Spain",
    "Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain",
    "Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houton, Texas, USA",
    "Pulmonary Department, Pulmonary and Critical Care Division, Brigham and Women’s Hospital, Boston, Massachusetts, USA"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 23,
  "authors": [
    {
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        0
      ],
      "name": "Juan P. de-Torres"
    },
    {
      "affs": [
        1
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      "name": "Ciro Casanova"
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        2
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      "name": "José M. Marín"
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        2
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      "name": "Marta Marín-Oto"
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        3
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      "name": "Carlos Cabrera"
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      "name": "Juan A. Riesco"
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        5
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      "name": "Pablo Sanchez Salcedo"
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    {
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        6
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      "name": "Carlos Amado"
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    {
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        7
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      "name": "Nuria Toledo-Pons"
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        8
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      "name": "Ingrid Solanes"
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        9
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      "name": "Carolina Gotera"
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        10
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      "name": "Jessica Gonzalez"
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      "name": "Carlos Ruiz Martinez"
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        12
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      "name": "Aurora Solier López"
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    {
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        13
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      "name": "Francisco García Río"
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    {
      "affs": [
        14
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      "name": "Cruz González"
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      "name": "Antonia Fuster"
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      "name": "Tamara Alonso"
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      "name": "Ana Ezponda"
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      "name": "Gorka Bastarrika"
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    {
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      "name": "Verónica Hernández-Lopez"
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    {
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        19
      ],
      "name": "Francesca Polverino"
    },
    {
      "affs": [
        20
      ],
      "name": "Bartolome R. Celli"
    }
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  "bibtex": "https://research.draconitic.com/paper/4g1vwew19fx77.bib",
  "cited_by": 0,
  "doi": "10.1080/15412555.2026.2753977",
  "fulltext_url": "https://www.tandfonline.com/doi/10.1080/15412555.2026.2753977",
  "id": "4g1vwew19fx77",
  "issns": [
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    "1541-2555"
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  "landing_url": "https://doi.org/10.1080/15412555.2026.2753977",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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  "published": "2026-10-01",
  "publisher": "Taylor & Francis Group",
  "ris": "https://research.draconitic.com/paper/4g1vwew19fx77.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T14:21:03Z",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC705-779",
      "subfield": "general"
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  "title": "Targeting Accelerated Aging in COPD: The AMICO (A Trial of Metformin In COpd) Trial Design",
  "title_text": "Targeting Accelerated Aging in COPD: The AMICO (A Trial of Metformin In COpd) Trial Design",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T14:20:29Z",
  "url": "https://research.draconitic.com/paper/4g1vwew19fx77",
  "venue": "COPD",
  "versions": []
}