Wolfgang Miesbach/LinkedIn
Feb 25, 2026, 12:36
Wolfgang Miesbach: Repurposing Metformin – From Sugar Control to Thrombus Control
Wolfgang Miesbach, Professor of Medicine at Frankfurt University Hospital, shared on LinkedIn:
”Repurposing Metformin: From Sugar Control to Thrombus Control
One of the many excellent posters at this year’s GTH 2026 meeting in Bonn was from the team in Düsseldorf, exploring an unexpected player in abdominal aortic aneurysm (AAA) therapy: the antidiabetic drug metformin.
Their work looks at how metformin modulates platelet activation and ex vivo thrombus formation in human whole blood – a fascinating angle, given the growing recognition that platelets and intraluminal thrombus are not just bystanders but active drivers of AAA progression:
- A ‘classic’ diabetes drug being repurposed to target vascular inflammation and thrombosis, in a disease area where truly effective pharmacological treatments are still lacking.
- Experimental data suggesting that metformin can inhibit platelet activation and arterial/venous thrombosis without prolonging bleeding time, by acting on mitochondrial pathways – hinting at a new, ‘metabolic’ form of antiplatelet therapy.
- Use of human samples and arterial‑shear thrombus assays keeps the model close to clinical reality and directly links cellular mechanisms to the thrombotic milieu observed in AAA.
- The concept that dampening platelet hyperreactivity might not only reduce thrombotic complications but also slow aneurysm expansion is particularly attractive and could complement ongoing clinical trials of metformin in AAA.”

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