GLP-1 Receptor Agonists in the Treatment of Polycystic Ovary Syndrome and Compare with Metformin a Systematic Review Study

Backgrounds: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in females and is often associated with a number of cardiometabolic disorders such as central obesity, dyslipidaemia, hypertension, insulin resistance, glucose intolerance and type 2 diabetes mellitus. A primary treatment goal is weight reduction. The weight loss effects of glucagon-like peptide-1 receptor agonists (GLP-1RA), previously demonstrated in diabetic and obese non-diabetic patients, offer a unique opportunity to expand the medical options available to PCOS patients.Material and method : Electronic databases (PubMed, EMBASE, Cochrane Library) dating from their establishment to June 2019 were searched to find all randomized controlled trials (RCTs) reporting the efficacy of GLP-1RA therapy in PCOS and compare with Metformin. Result:The available studies of GLP-1RA therapy in the treatment of excess body weight in women with PCOS demonstrate that it is effective in weight reduction either as monotherapy or in combination with Metformin. A few studies showed that androgens may be modestly decreased and menstrual frequency may be increased. Eating behavior may be improved with GLP-1RA therapy and glucose parameters are generally improved. GLP-1RAs were well-tolerated, with nausea being the most significant adverse side effect. Compared with Metformin, GLP-1RAs were more effective in improving insulin sensitivity (standard mean difference [SMD] -0.40, 95% confidence interval [CI] -0.74 to -0.06, P = 0.02), reducing body mass index (SMD -1.02, 95% CI -1.85 to -0.19, P = 0.02) and abdominal girth (SMD -0.45, 95% CI -0.89 to -0.00, P = 0.05). GLP-1RAs were associated with a higher incidence of nausea and headache than Metformin, but there were no significant differences in other data.Conclusion: Based on studies, GLP-1RA is a good method to control patients with PCOS and compared with Metformin, might be a good choice for obese patients, especially those with insulin resistance. More high-quality research is needed to assess the efficacy of a GLP-1RA on women with PCOS.