Reimbursement of metformin for polycystic ovary syndrome

Milewicz, Andrzej

doi:10.5603/ep.2013.0025

Cited by 13 publications

(15 citation statements)

References 62 publications

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“…1). 3,11,15 Recent reports have revealed a close correlation between mental disorders and clinical PCOS symptoms such as acne, hirsutism, infertility, obesity and a poorer quality of life. A higher frequency of depression, drug-related and bipolar disorders, bulimia, anorexia or non-spe- 12 Chronic hyperandrogenemia, which leads to increased aromatization of androgens to estrogens in adipose tissue, may contribute further to the development of hormone-dependent tumors, such as endometrial, mammary or ovary neoplasms.…”

Section: Discussionmentioning

confidence: 99%

“…It has also been suggested that the underlying causes of PCOS include increased frequency of gonadotropin-releasing hormone (GnRH) pulses that stimulate the theca cells to produce androgen; decreased levels of FSH (and thus a defect in the late luteal and early follicular phases); insulin resistance via a post-receptor defect in the fat tissue and skeletal muscles (abnormal phosphorylation of tyrosine kinase); pancreatic beta-cell dysfunction; and obesity. 1,3 It is often impossible to determine definitively what is a cause and what is an effect in the development of PCOS. In addition, it is generally recognized that obesity increases menstrual disorders and hyperandrogenism, while weight reduction reduces the clinical signs.…”

Section: Etiopathogenesismentioning

confidence: 99%

“…[1][2][3] Despite these seemingly clear criteria, the etiology of PCOS remains unknown, and precise treatment procedures have not been established. PCOS therefore continues to be the object of research and scientific inquiry.…”

mentioning

confidence: 99%

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The pathogenesis and treatment of polycystic ovary syndrome: What’s new?

Bednarska¹,

Siejka²

2017

Adv Clin Exp Med

227

148

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Polycystic ovary syndrome (PCOS) is currently the leading cause of menstrual complications in women. It is characterized by clinical and/or biochemical hyperandrogenism, ovulation abnormalities and the presence of enlarged and/or polycystic ovaries in ultrasound images (12 or more small bubbles located circumferentially and/or ovarian volume > 10 mL). It is often comorbid with hyperinsulinemia, dyslipidemia, overweight or obesity, and is a risk factor for the development of diabetes and cardiovascular diseases (CVDs). The treatment of patients with PCOS depends on the prevailing symptoms. The aim of this paper is to present the etiopathogenesis, clinical and biochemical implications, and non-pharmacological and pharmacological treatment options -those approved by worldwide scientific organizations as well as new therapies whose initial results are encouraging enough to prompt researchers to explore them further.

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Section: Discussionmentioning

confidence: 99%

Section: Etiopathogenesismentioning

confidence: 99%

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The pathogenesis and treatment of polycystic ovary syndrome: What’s new?

Bednarska¹,

Siejka²

2017

Adv Clin Exp Med

227

148

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“… 5 However, several trials have failed to observe any significant improvement in lipid profile after metformin treatment. 6 7 The use of statins has recently emerged as a novel therapeutic approach to PCOS. 8 Treatments using statins, and combined statins and metformin can effectively improve IR, fasting insulin (F-INS), insulin sensitivity index, 9 hyperandrogenemia, 10 hirsutism, acne, 11 testosterone 10 and decreasing C reactive protein (CRP).…”

Section: Introductionmentioning

confidence: 99%

An investigation into the therapeutic effects of statins with metformin on polycystic ovary syndrome: a meta-analysis of randomised controlled trials

et al. 2015

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ObjectivesTo investigate the therapeutic effects of statins with metformin on polycystic ovary syndrome (PCOS).SettingsEndocrinology department.ParticipantsMEDLINE, EMBASE and Cochrane Central Register of Controlled Trials were searched until October 2014. Studies comparing statins and placebo, as well as the combination of statins and metformin and metformin alone, were included in the analysis.InterventionsData were independently extracted by two researchers; any convergence was resolved by a third reviewer.Primary and secondary outcome measuresThe following properties were extracted from the qualified trials to identify the effects of statins: clinical variables, metabolic characteristics, hormone outcomes, sign of inflammation, glucose parameters and insulin outcomes.ResultsData from four trials comparing statin and metformin with metformin alone were analysed. The combination of statins and metformin decreases the levels of C reactive protein (standardised mean difference (SMD) −0.91; 95% CI −1.81 to −0.02; p=0.046), triglyceride (SMD −1.37; 95% CI −2.46 to −0.28; p=0.014), total cholesterol (SMD −1.28; 95% CI −1.59 to −0.97; p=0.000) and low-density lipoprotein (LDL) cholesterol (SMD −0.74; 95% CI −1.03 to −0.44; p=0.000). However, the combined therapy fails to reduce fasting insulin (SMD −0.92; 95% CI −2.07 to 0.24; p=0.120), homeostasis model assessment of insulin resistance (SMD −1.15; 95% CI −3.36 to 1.06; p=0.309) and total testosterone (SMD −1.12; 95% CI −2.29 to 0.05; p=0.061). Analysis of the five trials comparing statin with placebo shows that statin monotherapy reduces LDL-cholesterol, triglyceride and total cholesterol.ConclusionsCombined statin and metformin therapy can improve lipid and inflammation parameters, but cannot effectively improve insulin sensitivity and reduce hyperandrogenism in women with PCOS. A large-scale randomised controlled study must be conducted to ascertain the long-term effects of the therapy.

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“…Metformin stops proliferation of cell by by reducing the VEGF levelscontrolling neo vascularisation of tumour. At hormonal level it induces progesterone receptor thereby increasing the response to hormonal therapy [16]. glyoxalase I (GLO1), an enzyme that detoxifies methylglyoxal, is selectively overexpressed in the apoptosis-resistant cancer cells [17].…”

Section: Other Mechanism Of Anti-proliferative Activity Miscellaneousmentioning

confidence: 99%

Metformin in Ovarian Cancer

Bose¹,

Basu²

2017

J Oncol Transl Res

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Metformin after its discovery has found many wonders in many varied uses, poly cystic ovarian disease being already established one. It is now standard therapy in such condition. Many enchanting pathways are depicted leading to its many efficacies. In last decade its use in ovarian and other cancers is proposed. Before another such use is proved we can see the subject had grown bigger; hence a review seems to be worthwhile.

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Reimbursement of metformin for polycystic ovary syndrome

Cited by 13 publications

References 62 publications

The pathogenesis and treatment of polycystic ovary syndrome: What’s new?

The pathogenesis and treatment of polycystic ovary syndrome: What’s new?

An investigation into the therapeutic effects of statins with metformin on polycystic ovary syndrome: a meta-analysis of randomised controlled trials

Metformin in Ovarian Cancer

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