International Journal of Endocrinology

Review Article

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

Table 1

Characteristics of the included studies.
AuthorYearCountryStudy designParticipantsPCOS diagnostic criteriaSample sizeAge (mean ± SD)ControlInterventionDuration (week)Outcome
ConIntConInt
Ali et al. [19]2019PakistanTwo arms, open-label RCTPCOS womenESHRE/ASRM guidelines535325.6 ± 4.525.4 ± 3.7Met, 1000 mg/dayMet, 1000 mg/day and PGZ 30 mg/day121, 2, 5, 6, 11, 12, 13, 14
Baillargeon et al. [20]2004VenezuelaFour arms, double-blind RCTNonobese PCOS women with normal insulin sensitivityNR282027.7 ± 0.927.5 ± 1.1Met, 850 mg/dayMet, 850 mg/day and RSG 4 mg/day241, 2, 4, 5, 14, 15, 16, 18, 19
Daneshjou et al. [21]2022IranFour arms, double-blind RCTPCOS women candidate for ICSIESHRE/ASRM guidelines151528.9 ± 2.730.2 ± 3.1Met, 1000 mg/dayMet, 1000 mg/day and SITA 100 mg/day86, 12, 13, 16
Elkind-Hirsch et al. [22]2008USAThree arms, open-label RCTOverweight and obese PCOS womenRotterdam criteria202027.7 ± 1.332.1 ± 0.7Met, 2000 mg/dayMet, 2000 mg/day and EX 20 μg/day241, 2, 6, 7, 8, 9, 10, 14, 15, 16
Elkind-Hirsch et al. [23]2017USAThree arms, single-blind RCTPrediabetic PCOS womenNIH 1990 criteria121129.9 ± 729.6 ± 8Met, 2000 mg/dayMet, 2000 mg/day and SAXA 5 mg/day162, 3, 5, 6, 7, 8, 9, 10, 14, 15, 16, 18, 19
Ferjan et al. [24]2017SloveniaTwo arms, open-label RCTObese PCOS women pretreated with LIRNR121234.3 ± 6.8MET, 2000 mg/dayMet, 2000 mg/day and SITA 100 mg/day121, 2, 3, 6, 7, 8, 9, 10, 11, 12, 14, 15
Sever et al. [25]2014SloveniaThree arms, open-label RCTObese PCOS women pretreated with metNR141131.3 ± 9.431.1 ± 5.5Met, 2000 mg/dayMet, 2000 mg/day and LIR 1.2 mg/day121, 2, 3, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 18, 19
Li et al. [15]2020ChinaThree arms, open-label RCTObese PCOS womenRotterdam criteria686925.8 ± 4.425.9 ± 4Met, 1500 mg/dayMet, 1000 mg/day and RSG 4 mg/day241, 2, 3, 4, 5, 6, 7, 8, 9, 10, 14
Liao et al. [26]2011ChinaThree arms, open-label RCTObese PCOS womenRotterdam criteria282727.7 ± 2.927 ± 3.2Met, 1500 mg/dayMet, 1500 mg/day and RSG 4 mg/day245, 6, 7, 9, 11, 12, 14
Ma et al. [27]2021ChinaTwo arms, open-label RCTOverweight and obese PCOSRotterdam criteria252528.1 ± 4.430.1 ± 4.5Met, 1500 mg/dayMet, 1500 mg/day and EX 2 mg/week121, 2, 3, 5, 6, 7, 8, 9, 10, 14, 16
Sohrevardi et al. [16]2016IranThree arms, open-label RCTPCOS womenRotterdam criteria222328.7 ± 6.330.7 ± 6.1Met, 1500 mg/dayMet, 1500 mg/day and PGZ 30 mg/day121, 2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 16
Tao et al. [28]2018ChinaThree arms, open-label RCTPCOS women with new-onset T2DMRotterdam criteria212128 ± 329 ± 5Met, 2000 mg/dayMet, 2000 mg/day and SAXA 5 mg/day241, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 20
Tao et al. [29]2021ChinaThree arms, open-label RCTOverweight and obese prediabetic PCOS womenRotterdam criteria5050NRNRMet, 2000 mg/dayMet, 2000 mg/day and EX 20 μg/day121, 2, 7, 8, 9, 10, 11, 12, 14, 15, 16
Wen et al. [30]2023ChinaTwo arms, open-label RCTObese PCOS womenRotterdam criteria303025.4 ± 3.126.7 ± 4.4Met, 1700 mg/dayMet, 1700 mg/day and beinaglutide 0.6 mg/day121, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14
Xing et al. [31]2022ChinaTwo arms, open-label RCTOverweight PCOS womenRotterdam criteria252723.5 ± 4.625.8 ± 4.4Met, 2000 mg/dayMet, 2000 mg/day and LIR 1.2 mg/day4 & 121, 2, 5, 6, 11, 12, 13, 14, 15, 17
Zhang et al. [32]2022ChinaTwo arms, open-label RCTOverweight and obese PCOS womenRotterdam criteria202125.5 ± 4.326.3 ± 5.8Met, 2000 mg/dayMet, 2000 mg/day and CANA 100 mg/day121, 2, 5, 6, 7, 8, 9, 11, 12, 14, 15
Outcomes are summarized as follows: 1, weight; 2, body mass index; 3, waist circumference; 4, waist-to-hip ratio; 5, fasting blood sugar; 6, HOMA-IR; 7, triglyceride; 8, total cholesterol; 9, LDL-C; 10, HDL-C; 11, LH; 12, FSH; 13, prolactin; 14, testosterone; 15, SHBG; 16, DHEA-S; 17, progesterone; 18, systolic blood pressure; 19, diastolic blood pressure; 20, HbA1C. RCT, randomized clinical trial; PCOS, polycystic ovary syndrome; Con, control; Int, intervention; NR, not reported; ICSI, intracytoplasmic sperm injection; Met, metformin; PGZ, pioglitazone; RSG, rosiglitazone; SITA, sitagliptin; EX, exenatide; SAXA, saxagliptin; LIR, liraglutide; CANA, canagliflozin.