Combined oral contraceptives and/or antiandrogens versus insulin sensitizers for polycystic ovary syndrome: a systematic review and meta-analysis

Luque‐Ramírez, Manuel; Nattero‐Chávez, Lía; Ortiz-Flores, A.E.; Escobar-Morreale, Héctor F.

doi:10.1093/humupd/dmx039

Cited by 42 publications

(28 citation statements)

References 128 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…According to the quality evaluation of the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0, the following aspects were assessed for all RCTs included in this study: random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, selective reporting, and other bias. The risk of bias was assessed as being high if any of these domains were assessed as being at unclear or high risk of bias.…”

Section: Methodsmentioning

confidence: 99%

Autologous platelet‐rich gel treatment for diabetic chronic cutaneous ulcers: A meta‐analysis of randomized controlled trials

Gao

et al. 2018

Journal of Diabetes

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

Autologous platelet‐rich gel treatment for diabetic chronic cutaneous ulcers: A meta‐analysis of randomized controlled trials

Gao

et al. 2018

Journal of Diabetes

View full text Add to dashboard Cite

show abstract

“…Future high-quality long-term RCTs are needed to confirm these findings. Recent adult systematic review with pairwise meta-analysis showed no statistically important difference between OCP and insulin sensitizers with regard to fasting glucose level only [ 44 ]. The study did not evaluate other glycemic indexes like 2-hour oral glucose tolerance test or hemoglobin A1c.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Treatments for Polycystic Ovarian Syndrome Management in Adolescents

Khalifah

Flórez

Zoratti

et al. 2020

Journal of the Endocrine Society

View full text Add to dashboard Cite

Limited evidence on treatment options for polycystic ovarian syndrome (PCOS) has led to considerable variation in healthcare practices. We aimed to compare the effects of metformin and/or oral contraceptive pills (OCPs) in combination with pioglitazone, spironolactone, flutamide, and lifestyle interventions among adolescents aged 11-19 years with PCOS. Literature searches were performed in Medline, Embase, and the Cochrane Central Register of Controlled Trials from database inception through December 2018, with no language restriction. Two reviewers screened titles and abstracts, assessed full text eligibility, and extracted information from eligible trials. Evidence was synthesized through network meta-analyses (NMA) using Bayesian random-effects approach. We identified 37 RCTs, in which 2400 patients were randomized. NMA showed no statistically important difference among all interventions to improve menstrual regulation, or body mass index. Moderate quality evidence showed hirsutism scores were reduced by multiple interventions that included single and combination medications namely; lifestyle intervention, metformin, OCP, spironolactone, pioglitazone, metformin-OCP, metformin-spironolactone, metformin-flutamide, against placebo. Moderate quality evidence showed OCP results in more dysglycaemia compared to metformin (odds ratio 2.98; 95%credible interval 1.02, 8.96), no intervention resulted in dysglycaemia reduction. In conclusion, metformin and OCP as monotherapy or in combination with other interventions compared to placebo can reduce hirsutism scores, but none of these medications lead to effective menstrual cycle regulation or weight reduction. However, the use of OCP leads to worse cardiometabolic risk factors. Further research into new treatment options is urgently needed.

show abstract

“…Treating hirsutism in women is a delicate process and must always be appropriately balanced against the potential adverse effects of the medication used. This being said, many treatment options exist for both young girls, and adult women [29].…”

Section: Discussionmentioning

confidence: 99%

Clinical, hormonal and metabolic parameters in women with PCOS with different combined oral contraceptives (containing chlormadinone acetate versus drospirenone)

Podfigurna

Męczekalski

Luisi

2019

J Endocrinol Invest

View full text Add to dashboard Cite

Introduction Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting 5-10% of women of reproductive age. It is characterized by chronic anovulation leading to menstrual disorders, and increased infertility. The syndrome can also manifest as hirsutism and acne. Aim of the study The aim of the study was to compare, over a duration of 6 months, the effects of drospirenone (DRSP) versus chlormadinone acetate (CMA) containing oral contraceptives (OCs) on clinical, hormonal, and metabolic parameters in 120 PCOS women. Materials and methods 120 women with the diagnosis of PCOS according to the Rotterdam 2003 criteria were recruited to the study. All patients were divided to two treatment groups of OCs, containing: 3 mg DRSP/30 mcg EE (ethinylestradiol) (60 patients) and 2 mg CMA/30 mcg EE (60 patients). Clinical parameters such as hirsutismus and acne were evaluated. Metabolic parameters such as serum insulin, glucose concentration, homeostatic model assessment of insulin resistance, body mass index, systolic and diastolic blood pressures were also measured. Among hormonal parameters, serum estradiol, luteinizing hormone, follicle-stimulating hormone, prolactin, testosterone, dehydroepiandrosterone sulfate, thyroid-stimulating hormone, and free thyroxine were measured. Results The use of both DRSP-or CMA-containing OCs provided similar positive therapeutic effects with regard to clinical, metabolic, and hormonal parameters. Among clinical parameters, like hirsutismus, after 6 months of continuous OC treatment, a statistically significant improvement was observed in both groups: DRSP (p < 0.0001) and CMA OC treatment (p < 0.0001). In addition, significant improvement was showed according to acne lesions both after DRSP (p < 0.0001) and CMA treatments (p < 0.0001). Among glucose, insulin levels and HOMA-IR, there were statistically significant higher levels in both groups after DRSP (p < 0.0001, p < 0.0001, p < 0.05) and CMA OC treatment (p < 0.02, p < 0.0001, p < 0.0001). Hormonal parameters such as LH, FSH, prolactin, testosterone and DHEA-S were statistically significant lower in both groups after DRSP (p < 0.0001, p < 0.0001, p < 0.01, p < 0,002, and p < 0.0001) and CMA OC treatment (p < 0.0001, p < 0.0001, p < 0.04, p < 0.002, and p < 0.0001). Conclusions Further research, however, is needed not only to define optimal duration, and to clarify the effects of treatment on long-term metabolic outcomes, but also to explore different treatment options and possible combined therapies.

show abstract

Combined oral contraceptives and/or antiandrogens versus insulin sensitizers for polycystic ovary syndrome: a systematic review and meta-analysis

Abstract: CRD42016053457.

Cited by 42 publications

References 128 publications

Autologous platelet‐rich gel treatment for diabetic chronic cutaneous ulcers: A meta‐analysis of randomized controlled trials

Autologous platelet‐rich gel treatment for diabetic chronic cutaneous ulcers: A meta‐analysis of randomized controlled trials

Efficacy of Treatments for Polycystic Ovarian Syndrome Management in Adolescents

Clinical, hormonal and metabolic parameters in women with PCOS with different combined oral contraceptives (containing chlormadinone acetate versus drospirenone)

Contact Info

Product

Resources

About