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Achat metformine 850 mg (Garlick), metformin 900 (Oscar Fischer), or placebo was evaluated during the first 4 weeks of treatment. The primary endpoint efficacy and safety was assessed by the investigator's investigator blinded to drug dose study a secondary end point of overall symptomatology. The primary endpoint was considered to be clinically significant if at least 60% of patients achieving 75% Metformine zonder recept kopen reduction in score at Week 4 had achieved least 50% reduction at Week 5. The secondary end point was not considered clinically significant if no patients achieved at least 50% reduction any point during the study period. Patients were enrolled with an outpatient consultation and the patient completed baseline assessment, which asked for demographic and clinical details. data was retrieved from these records and compared with a matched control cohort of random sample patients from each study center at the time of enrollment. Data regarding the occurrence of adverse events were retrospectively obtained through patient interviews and medical history. Adverse events were defined as clinically significant, with or without a diagnosis. Adverse events reported during the study were determined to be related the administration of metformin, according to the criteria of American College Asthma and Allergy, the American Thoracic Society, College of Physicians, and the European Respiratory Society.9 grade of evidence assigned for each adverse event was based on the National Institute of Allergy and Infectious Diseases' Criteria for Adverse Events in Clinical Trials (NIAID's Criteria) for Adverse Events in Clinical Trials.10 Outcomes were the primary outcome measures of study. Secondary end points included global improvement in patient self-reported chronic bronchitis and the incidence of adverse events to measure quality of life. Statistical Analysis An unaltered control cohort was created for each study center, consisting of individuals with stable chronic bronchitis, as in our randomized controlled study, with no history of therapy. These controls were selected randomly from each study center's population. cohort included up to two individual controls per treatment group. An equal distribution was then applied to the data from treatment and unexposed cohorts. There was no treatment difference between the and control groups in terms of baseline demographics, medical conditions, medication use, or comorbid except for the metformin group. The primary analyses were performed in accordance with the CONSORT statement for reporting of randomized clinical trials.11 This was to avoid selection bias and reduce the risk of bias during evaluation possible outcomes. The CONSORT statement is an evidence-based standard for reporting controlled randomized clinical trials (RCTs),12 and it has been translated into several languages and is supported by the American Cancer Society.13-16 Data were analyzed in descriptive fashion without data extraction on the basis of either intention-to-treat or intention-to-failure.17 Statistical comparisons between treatment groups and controls were performed by a logistic regression analysis. The approach allows specification and analysis of the number participants for each treatment and control group to increase the specificity. For all analyses, a power model was fitted to examine the dose-response relationship.17 For statistical analyses, two-tailed tests were used to test for the significance of differences between study groups. Tests were not corrected for multiple comparisons. All other results presented are the paired means. Standard deviations are in parentheses. Results Study population Four study centers (Boston, Pittsburgh, Los Angeles, and Philadelphia)