TY - JOUR
T1 - Anti-obesity pharmacological agents for polycystic ovary syndrome
T2 - A systematic review and meta-analysis to inform the 2023 international evidence-based guideline
AU - Goldberg, Alyse
AU - Graca, Sandro
AU - Liu, Jing
AU - Rao, Vibhuti
AU - Witchel, Selma Feldman
AU - Pena, Alexia
AU - Li, Rong
AU - Mousa, Aya
AU - Tay, Chau Thien
AU - Pattuwage, Loyal
AU - Teede, Helena
AU - Yildiz, Bulent O
AU - Ee, Carolyn
PY - 2024/5
Y1 - 2024/5
N2 - This systematic review and meta-analysis evaluated the efficacy of anti-obesity agents for hormonal, reproductive, metabolic, and psychological outcomes in polycystic ovary syndrome (PCOS) to inform the 2023 update of the International Evidence-based Guideline on PCOS. We searched Medline, EMBASE, PsycInfo, and CINAHL until July 2022 with a 10-year limit to focus on newer agents. Eleven trials (545 and 451 participants in intervention and control arms respectively, 12 comparisons) were included. On descriptive analyses, most agents improved anthropometric outcomes; liraglutide, semaglutide and orlistat appeared superior to placebo for anthropometric outcomes. Meta-analyses were possible for two comparisons (exenatide vs. metformin and orlistat + combined oral contraceptive pill [COCP] vs. COCP alone). On meta-analysis, no differences were identified between exenatide versus metformin for anthropometric, biochemical hyperandrogenism, and metabolic outcomes, other than lower fasting blood glucose more with metformin than exenatide (MD: 0.10 mmol/L, CI 0.02–0.17, I2 = 18%, 2 trials). Orlistat + COCP did not improve metabolic outcomes compared with COCP alone (fasting insulin MD: −8.65 pmol/L, −33.55 to 16.26, I2 = 67%, 2 trials). Published data examining the effects of anti-obesity agents in women with PCOS are very limited. The role of these agents in PCOS should be a high priority for future research.
AB - This systematic review and meta-analysis evaluated the efficacy of anti-obesity agents for hormonal, reproductive, metabolic, and psychological outcomes in polycystic ovary syndrome (PCOS) to inform the 2023 update of the International Evidence-based Guideline on PCOS. We searched Medline, EMBASE, PsycInfo, and CINAHL until July 2022 with a 10-year limit to focus on newer agents. Eleven trials (545 and 451 participants in intervention and control arms respectively, 12 comparisons) were included. On descriptive analyses, most agents improved anthropometric outcomes; liraglutide, semaglutide and orlistat appeared superior to placebo for anthropometric outcomes. Meta-analyses were possible for two comparisons (exenatide vs. metformin and orlistat + combined oral contraceptive pill [COCP] vs. COCP alone). On meta-analysis, no differences were identified between exenatide versus metformin for anthropometric, biochemical hyperandrogenism, and metabolic outcomes, other than lower fasting blood glucose more with metformin than exenatide (MD: 0.10 mmol/L, CI 0.02–0.17, I2 = 18%, 2 trials). Orlistat + COCP did not improve metabolic outcomes compared with COCP alone (fasting insulin MD: −8.65 pmol/L, −33.55 to 16.26, I2 = 67%, 2 trials). Published data examining the effects of anti-obesity agents in women with PCOS are very limited. The role of these agents in PCOS should be a high priority for future research.
KW - anti-obesity agents
KW - GLP1 receptor agonists, meta-analysis
KW - polycystic ovary syndrome
UR - http://www.scopus.com/inward/record.url?scp=85190496185&partnerID=8YFLogxK
U2 - 10.1111/obr.13704
DO - 10.1111/obr.13704
M3 - Review article
C2 - 38355887
AN - SCOPUS:85190496185
SN - 1467-7881
VL - 25
JO - Obesity Reviews
JF - Obesity Reviews
IS - 5
M1 - e13704
ER -
