| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated | 
| Rheumatoid arthritis, SLE, Polymyalgia rheumatica, Disthyroid eye disease, Cushing's syndrome |  | 
| MedDRA Classification | 
| E.1.3 | Condition being studied is a rare disease | No | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial | 
| This proposal aims to prevent or treat the deleterious metabolic consequences of glucocorticoids in patients with glucocorticoid excess |  | 
| E.2.2 | Secondary objectives of the trial | 
| To identify various metabolic parameters which might improve with the suggested therapy |  | 
| E.2.3 | Trial contains a sub-study | No | 
| E.3 | Principal inclusion criteria | 
| Inclusion Criteria for patients to be included in the “Prevention” arm ·	Patients diagnosed with a rheumatological disease and not started yet on GC treatment
 ·	minimal duration of prospective therapy 12w
 ·	dose of prednisolone ≥10mg/d (or equivalent GC)
 ·	ambulatory patients
 ·	patients >18 years and <or =75 yrsold
 ·	ability to understand verbal and written instructions and informed consent
 
 Inclusion Criteria for patients to be included in the “Treatment” arm
 ·	Patients treated with GC >20mg/d for at least 4wks
 ·	minimal duration of prospective therapy 12w
 ·	dose of prednisolone ≥10mg/d (or equivalent GC)
 ·	ambulatory patients
 ·	patients >18 years old
 ·	ability to understand verbal and written instructions and informed consent
 
 Inclusion Criteria for patients diagnosed with Cushing’s syndrome
 ·	Patients diagnosed with Cushing’s syndrome
 ·	ambulatory patients
 ·	patients >18 years old
 ·	ability to understand verbal and written instructions and informed consent
 ·
 Exclusion Criteria
 ·	Prior therapy with metformin during the last 6 months
 ·	pre-existing diabetes
 ·	pregnancy
 ·	liver impairment: ALT and/or AST ≥2.5 x upper normal limit
 ·	renal impairment: serum creatinine levels ≥135.0 µmol/L in males and ≥110.0 µmol/L in females
 ·	current malignancy
 ·	patients unable to give written informed consent
 ·	or patients not understanding English and no translation available
 
 |  | 
| E.4 | Principal exclusion criteria | 
| ·	Prior therapy with metformin during the last 6 months ·	pre-existing diabetes
 ·	pregnancy
 ·	liver impairment: ALT and/or AST ≥2.5 x UNL
 ·	renal impairment: serum creatinine levels ≥135.0 µmol/L in males and ≥110.0 µmol/L in females
 ·	current malignancy
 ·	patients unable to give written informed consent
 ·	or patients not understanding English and no translation available
 |  | 
| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| Change in visceral to subcutaneous fat area ratio as assessed by CT. |  | 
| E.6 and E.7 Scope of the trial | 
| E.6 | Scope of the trial | 
| E.6.1 | Diagnosis | Information not present in EudraCT | 
| E.6.2 | Prophylaxis | Yes | 
| E.6.3 | Therapy | Yes | 
| E.6.4 | Safety | Information not present in EudraCT | 
| E.6.5 | Efficacy | Information not present in EudraCT | 
| E.6.6 | Pharmacokinetic | Information not present in EudraCT | 
| E.6.7 | Pharmacodynamic | Information not present in EudraCT | 
| E.6.8 | Bioequivalence | Information not present in EudraCT | 
| E.6.9 | Dose response | Information not present in EudraCT | 
| E.6.10 | Pharmacogenetic | Information not present in EudraCT | 
| E.6.11 | Pharmacogenomic | Information not present in EudraCT | 
| E.6.12 | Pharmacoeconomic | Information not present in EudraCT | 
| E.6.13 | Others | Information not present in EudraCT | 
| E.7 | Trial type and phase | 
| E.7.1 | Human pharmacology (Phase I) | No | 
| E.7.1.1 | First administration to humans | Information not present in EudraCT | 
| E.7.1.2 | Bioequivalence study | Information not present in EudraCT | 
| E.7.1.3 | Other | Information not present in EudraCT | 
| E.7.1.3.1 | Other trial type description |  | 
| E.7.2 | Therapeutic exploratory (Phase II) | Yes | 
| E.7.3 | Therapeutic confirmatory (Phase III) | No | 
| E.7.4 | Therapeutic use (Phase IV) | No | 
| E.8 Design of the trial | 
| E.8.1 | Controlled | Yes | 
| E.8.1.1 | Randomised | Yes | 
| E.8.1.2 | Open | Information not present in EudraCT | 
| E.8.1.3 | Single blind | Information not present in EudraCT | 
| E.8.1.4 | Double blind | Yes | 
| E.8.1.5 | Parallel group | Information not present in EudraCT | 
| E.8.1.6 | Cross over | Information not present in EudraCT | 
| E.8.1.7 | Other | Information not present in EudraCT | 
| E.8.2 | Comparator of controlled trial | 
| E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT | 
| E.8.2.2 | Placebo | Yes | 
| E.8.2.3 | Other | Information not present in EudraCT | 
| E.8.3 | The trial involves single site in the Member State concerned | Yes | 
| E.8.4 | The trial involves multiple sites in the Member State concerned | No | 
| E.8.5 | The trial involves multiple Member States | No | 
| E.8.6 Trial involving sites outside the EEA | 
| E.8.6.1 | Trial being conducted both within and outside the EEA | No | 
| E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT | 
| E.8.7 | Trial has a data monitoring committee | No | 
| E.8.8 | Definition of the end of the trial and justification where it is not the last
                        visit of the last subject undergoing the trial | 
| Trial will be considered ended when all the analysis of the study data will be completed, within one year of the last visit of the last subject. |  | 
| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 4 | 
| E.8.9.1 | In the Member State concerned months | 3 | 
| E.8.9.1 | In the Member State concerned days | 0 | 
| E.8.9.2 | In all countries concerned by the trial years | 4 | 
| E.8.9.2 | In all countries concerned by the trial months | 3 | 
| E.8.9.2 | In all countries concerned by the trial days | 0 |