Comparative Effectiveness of Antidiabetic Drugs as an Additional Therapy to Metformin in Women with Polycystic Ovary Syndrome: A Systematic Review of Metabolic Approaches

Background. Metformin is commonly prescribed to treat polycystic ovary syndrome (PCOS) patients, but in some cases, it may not be effective even at high doses or may cause intolerable side effects. Therefore, recent studies have examined the impact of combining metformin with other antidiabetic medi...

Full description

Saved in:
Bibliographic Details
Main Authors: Maryam Heidarpour, Mehrzad Mojarad, Sadegh Mazaheri-Tehrani, Ali Kachuei, Arash Najimi, Davood Shafie, Hassan Rezvanian
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:International Journal of Endocrinology
Online Access:http://dx.doi.org/10.1155/2024/9900213
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849682886114934784
author Maryam Heidarpour
Mehrzad Mojarad
Sadegh Mazaheri-Tehrani
Ali Kachuei
Arash Najimi
Davood Shafie
Hassan Rezvanian
author_facet Maryam Heidarpour
Mehrzad Mojarad
Sadegh Mazaheri-Tehrani
Ali Kachuei
Arash Najimi
Davood Shafie
Hassan Rezvanian
author_sort Maryam Heidarpour
collection DOAJ
description Background. Metformin is commonly prescribed to treat polycystic ovary syndrome (PCOS) patients, but in some cases, it may not be effective even at high doses or may cause intolerable side effects. Therefore, recent studies have examined the impact of combining metformin with other antidiabetic medications. Methods. A systematic search was performed in Scopus, PubMed, Web of Science, and Embase up to 30 June 2023. All interventional studies that assessed the efficacy of different antidiabetic agents were included. Results. Among the 3488 records found in the primary search, 16 papers were included. Our study showed that dipeptidyl peptidase-4 inhibitors (DPP4i) had the most significant impact on glycemic profile, while thiazolidinediones (TZDs) had the most influence on lipid levels. However, it was observed that patients taking only metformin experienced a greater increase in high-density lipoprotein cholesterol (HDL-C) levels. Glucagon-like peptide-1 receptor agonists (GLP1RAs) effectively modified various anthropometric measurements, such as weight, body mass index, waist circumference, and waist-to-hip ratio. The effects of different antidiabetic drugs on hormone levels were inconclusive, although testosterone levels were more affected by GLP1RA, sodium-glucose cotransporter-2 inhibitors (SGLT2i), and TZDs. None of the combined therapies showed a significant change in blood pressure. Conclusion. Since PCOS is a metabolic disorder, choosing the best combination of antidiabetic drugs in the clinical course of PCOS patients will be very important. Today, it seems that we need a new metabolic approach for better treatment of the metabolic aspects of these patients.
format Article
id doaj-art-c8582db77d9d4de2979b980755217b6a
institution DOAJ
issn 1687-8345
language English
publishDate 2024-01-01
publisher Wiley
record_format Article
series International Journal of Endocrinology
spelling doaj-art-c8582db77d9d4de2979b980755217b6a2025-08-20T03:24:03ZengWileyInternational Journal of Endocrinology1687-83452024-01-01202410.1155/2024/9900213Comparative Effectiveness of Antidiabetic Drugs as an Additional Therapy to Metformin in Women with Polycystic Ovary Syndrome: A Systematic Review of Metabolic ApproachesMaryam Heidarpour0Mehrzad Mojarad1Sadegh Mazaheri-Tehrani2Ali Kachuei3Arash Najimi4Davood Shafie5Hassan Rezvanian6Isfahan Endocrine and Metabolism Research CenterIsfahan Endocrine and Metabolism Research CenterChild Growth and Development Research CenterIsfahan Endocrine and Metabolism Research CenterMedical Education DepartmentHeart Failure Research CenterIsfahan Endocrine and Metabolism Research CenterBackground. Metformin is commonly prescribed to treat polycystic ovary syndrome (PCOS) patients, but in some cases, it may not be effective even at high doses or may cause intolerable side effects. Therefore, recent studies have examined the impact of combining metformin with other antidiabetic medications. Methods. A systematic search was performed in Scopus, PubMed, Web of Science, and Embase up to 30 June 2023. All interventional studies that assessed the efficacy of different antidiabetic agents were included. Results. Among the 3488 records found in the primary search, 16 papers were included. Our study showed that dipeptidyl peptidase-4 inhibitors (DPP4i) had the most significant impact on glycemic profile, while thiazolidinediones (TZDs) had the most influence on lipid levels. However, it was observed that patients taking only metformin experienced a greater increase in high-density lipoprotein cholesterol (HDL-C) levels. Glucagon-like peptide-1 receptor agonists (GLP1RAs) effectively modified various anthropometric measurements, such as weight, body mass index, waist circumference, and waist-to-hip ratio. The effects of different antidiabetic drugs on hormone levels were inconclusive, although testosterone levels were more affected by GLP1RA, sodium-glucose cotransporter-2 inhibitors (SGLT2i), and TZDs. None of the combined therapies showed a significant change in blood pressure. Conclusion. Since PCOS is a metabolic disorder, choosing the best combination of antidiabetic drugs in the clinical course of PCOS patients will be very important. Today, it seems that we need a new metabolic approach for better treatment of the metabolic aspects of these patients.http://dx.doi.org/10.1155/2024/9900213
spellingShingle Maryam Heidarpour
Mehrzad Mojarad
Sadegh Mazaheri-Tehrani
Ali Kachuei
Arash Najimi
Davood Shafie
Hassan Rezvanian
Comparative Effectiveness of Antidiabetic Drugs as an Additional Therapy to Metformin in Women with Polycystic Ovary Syndrome: A Systematic Review of Metabolic Approaches
International Journal of Endocrinology
title Comparative Effectiveness of Antidiabetic Drugs as an Additional Therapy to Metformin in Women with Polycystic Ovary Syndrome: A Systematic Review of Metabolic Approaches
title_full Comparative Effectiveness of Antidiabetic Drugs as an Additional Therapy to Metformin in Women with Polycystic Ovary Syndrome: A Systematic Review of Metabolic Approaches
title_fullStr Comparative Effectiveness of Antidiabetic Drugs as an Additional Therapy to Metformin in Women with Polycystic Ovary Syndrome: A Systematic Review of Metabolic Approaches
title_full_unstemmed Comparative Effectiveness of Antidiabetic Drugs as an Additional Therapy to Metformin in Women with Polycystic Ovary Syndrome: A Systematic Review of Metabolic Approaches
title_short Comparative Effectiveness of Antidiabetic Drugs as an Additional Therapy to Metformin in Women with Polycystic Ovary Syndrome: A Systematic Review of Metabolic Approaches
title_sort comparative effectiveness of antidiabetic drugs as an additional therapy to metformin in women with polycystic ovary syndrome a systematic review of metabolic approaches
url http://dx.doi.org/10.1155/2024/9900213
work_keys_str_mv AT maryamheidarpour comparativeeffectivenessofantidiabeticdrugsasanadditionaltherapytometformininwomenwithpolycysticovarysyndromeasystematicreviewofmetabolicapproaches
AT mehrzadmojarad comparativeeffectivenessofantidiabeticdrugsasanadditionaltherapytometformininwomenwithpolycysticovarysyndromeasystematicreviewofmetabolicapproaches
AT sadeghmazaheritehrani comparativeeffectivenessofantidiabeticdrugsasanadditionaltherapytometformininwomenwithpolycysticovarysyndromeasystematicreviewofmetabolicapproaches
AT alikachuei comparativeeffectivenessofantidiabeticdrugsasanadditionaltherapytometformininwomenwithpolycysticovarysyndromeasystematicreviewofmetabolicapproaches
AT arashnajimi comparativeeffectivenessofantidiabeticdrugsasanadditionaltherapytometformininwomenwithpolycysticovarysyndromeasystematicreviewofmetabolicapproaches
AT davoodshafie comparativeeffectivenessofantidiabeticdrugsasanadditionaltherapytometformininwomenwithpolycysticovarysyndromeasystematicreviewofmetabolicapproaches
AT hassanrezvanian comparativeeffectivenessofantidiabeticdrugsasanadditionaltherapytometformininwomenwithpolycysticovarysyndromeasystematicreviewofmetabolicapproaches