This pilot study aims to investigate the tolerability and feasibility of using metformin as an adjuvant treatment for RRMS. Also, it aims to evaluate the preliminary evidence of its efficacy by analyzing outcomes related to immunology, clinical manifestations, and radiological findings.

Inclusion Criteria:

• Individuals between 18 and 50 years of age who met the 2017 McDonald criteria were recruited.
• Patients with RRMS and had an EDSS score below 7.0.
• Participants were required to have been on a stable IFNβ-1a regimen for at least six months before the commencement of the study.

Exclusion Criteria:

• Individuals taking metformin or other diabetes medications, pregnant, and breastfeeding females were excluded.
• Those with congestive heart failure, liver impairment, kidney dysfunction, or chronic respiratory conditions were not eligible to participate.
• Additionally, patients who had undergone corticosteroids before or within 4 weeks of the study's commencement were ineligible for participation.