Journal Article

The efficacy and safety of GLP-1 agonists in PCOS women living with obesity in promoting weight loss and hormonal regulation: A meta-analysis of randomized controlled trials

de Moura de Souza, Mariana, Cosendey Martins, Otavio, Ximenes Mendes, Beatriz, Rodrigues Defante, Maria Luiza, Austregésilo de Athayde De Hollanda Morais, Beatriz, Rodrigues, Adriane Maria, Martins Prizão, Vitória

2024

Overview

The efficacy of GLP1 receptor agonists (GLP1-RAs) in treating polycystic ovarian syndrome (PCOS) remains unclear. While GLP1-RAs are known to promote weight loss in patients with diabetes and living with obesity, their impact on weight reduction and hormonal regulation in women with PCOS is understudied. Therefore, we aimed to assess the efficacy of GLP1-RAs in PCOS women living with obesity through a meta-analysis, comparing their effects to placebo. The use of GLP1-RAs in PCOS women living with obesity can reduce body mass index and waist circumference as well as improve hyperinsulinism, and hyperandrogenism as well as normalize total testosterone, total cholesterol and HOMA-IR markers in PCOS women living with obesity. We systematically searched the PubMed, Cochrane Central, Scopus and Embase databases to identify randomized controlled trials (RCT) comparing GLP1-RAs versus placebo among women diagnosed with PCOS based on the Rotterdam Criteria. Our primary outcomes of interest included body mass index (BMI), triglycerides, waist circumference, total testosterone, total cholesterol, and HOMA-IR. We performed data extraction and quality assessment for studies that met the inclusion criteria. We pooled mean difference (MD) and 95 % confidence intervals (CI) with a random-effect model for continuous endpoints. We included 176 participants from four RCTs. Semaglutide and Liraglutide were used in 23 (13 %) and 103 (58 %) participants, respectively. GLP1-RAs use was associated with a significant reduction in waist circumference (MD: −5.16 cm; 95 % CI: −6.11 to −4.21; p ˂ 0.00001), body mass index (BMI) (MD: −2.42; 95 % CI: −3.10 to −1.74; p ˂ 0.00001), serum triglycerides (MD: −0.20; 95 % CI: −0.30 to −0.11; p ˂ 0.00001) and total testosterone levels (MD: −1.33; 95 % CI: −2.55 to −0.12; p = 0.03) when compared to placebo. There was no significant difference in total cholesterol (MD: −0.04; 95 % CI: −0.10 to 0.01; p = 0.15) and HOMA-IR (MD: −0.30; 95 % CI: −0.92 to 0.32; p = 0.35) levels. Adverse events information was available for 112 patients, where 49 had light side effects such as nausea and abdominal pain. The use of GLP1-RAs demonstrates efficacy in reducing BMI, triglycerides, waist circumference and total testosterone. There was no significant difference in total cholesterol and HOMA-IR levels. These results signify its viability as a favourable treatment option for managing PCOS symptoms in women living with obesity. •Our findings argue in favor of the use of GLP1-RAs for the treatment of PCOS.•GLP1-RAs reduced BMI, triglycerides, waist circumference, and total testosterone among overweight women with PCOS.•GLP1-RAs should be considered for treating overweight PCOS women who are intolerant to Metformin.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Adult / Body Mass Index / Female / GLP-1 receptor agonists / Glucagon-Like Peptide-1 Receptor - agonists / Humans / Hypoglycemic Agents - therapeutic use / Insulin Resistance / Kinases / Liraglutide - therapeutic use / Obesity / Obesity - blood / Obesity - complications / Obesity - drug therapy / Polycystic ovary syndrome / Polycystic Ovary Syndrome - blood / Polycystic Ovary Syndrome - complications / Polycystic Ovary Syndrome - drug therapy / Randomized Controlled Trials as Topic / Testosterone - blood / Treatment Outcome / Waist Circumference - drug effects / Weight Loss - drug effects