Potential New Pharmacological Approaches in Obese Women with Polycystic Ovary Syndrome

Abstract

Obesity is frequently present in women with polycystic ovary syndrome (PCOS). It aggravates the adverse features of the syndrome and increases the metabolic risk in this population. Weight management by lifestyle intervention often remains unsatisfactory and non-sustainable. In the present mini review we revised limited studies addressing the potential use of agents mediating through GLP-1 in PCOS. We reported that short-term intervention with long acting GLP-1 analogue liraglutide is associated with consistent BMI decrease in treatment naive obese women with PCOS and in those who had been previously poor responders to metformin and lifestyle modification. Metformin, a well-established therapy used in PCOS with high metabolic risk, was recognized as a mechanistically well-suited combination with liraglutide. Short-term intervention with liraglutide also improved eating behavior in obese PCOS. Furthermore, we discussed the potential association of genetic variability of GLP-1 receptor and interindividual differences in response to liraglutide regarding weight reduction. In addition, we challenged the original concept related to the enhancement of GLP-1 mediated action through phosphodiesterase 4 (PDE 4) inhibitions as a new potential therapeutic target in obesity-related population. We concluded that GLP-1 mediated agents are promising treatment strategies in the management of obese PCOS. However, larger sample size studies with longer durations of treatment may be required to examine potential benefits of these medications in decreasing metabolic risk and improving reproductive outcome in obese PCOS.