Atorvastatin therapy decreases androstenedione and dehydroepiandrosterone sulphate concentrations in patients with polycystic ovary syndrome: randomized controlled study

Sathyapalan, Thozhukat; Smith, Karen; Coady, Anne‐Marie; Atkin, Stephen L.

doi:10.1258/acb.2011.011071

Cited by 29 publications

(13 citation statements)

References 32 publications

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“…Three trials were identified among the included five trials. 13 15 18 The superiority of statins to placebo in reducing F-INS was not confirmed (SMD −0.28; 95% CI −2.49 to 1.92; p=0.800) and heterogeneity existed across the studies (I²=95.0%, p=0.000). The pooled effect of statins showed an increased FBG level (SMD 0.71; 95% CI 0.02 to 1.41; p=0.044), but without significant heterogeneity (I²=57.3%, p=0.096; figure 2 ).…”

Section: Resultsmentioning

confidence: 96%

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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Section: Resultsmentioning

confidence: 96%

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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“…The following treatments appeared to be ineffective for hirsutism: sibutramine clomiphene acarbose myo‐inositol D‐chiro‐inositol spearmint tea, camomile tea low‐frequency electroacupuncture statins cimetidine bromocriptine. …”

Section: Resultsmentioning

confidence: 99%

“…Search results are shown in Figure . We included 157 studies comprising 10 550 women . The mean age varied between 15 years and 46 years, and the overall mean was 25·4 years.…”

Section: Resultsmentioning

confidence: 99%

“…One‐third of the studies (48 of 157) reported data that could not be further analysed (Table S2; see Supporting Information) . The remaining 109 studies covered 133 comparisons (Table S3; see Supporting Information) . Although the minimal important difference for the FG score has not been established, a change score exceeding 7 was considered to be clinically important.…”

Section: Resultsmentioning

confidence: 99%

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Interventions for hirsutism excluding laser and photoepilation therapy alone: abridged Cochrane systematic review includingGRADEassessments

Zuuren

Fedorowicz

2016

Br J Dermatol

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Hirsutism is a common disorder with a major impact on quality of life. The most frequent cause is polycystic ovary syndrome. Effects of interventions (except laser and light-based therapies) were evaluated, including Grading of Recommendations Assessment, Development and Evaluation assessments. Searches included Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, Medline, Embase and five trials registers to June 2014. We included 157 randomized controlled trials (RCTs) with 10 550 participants. The majority were assessed as having a 'high risk' of bias (123 of 157). The quality of evidence was rated moderate to very low for most outcomes. Pooled data for an oral contraceptive (OCP) (ethinyl oestradiol and cyproterone acetate) compared with another OCP (ethinyl oestradiol and desogestrel) demonstrated that both treatments were effective in reducing Ferriman-Gallwey scores, but the mean difference (MD) was not statistically significant [-1·84, 95% confidence interval (CI): -3·86-0·18]. Flutamide was more effective than placebo in two studies (MD -7·60, 95% CI: -10·53 to -4·67 and MD -7·20, 95% CI: -10·15 to -4·25), as was spironolactone (MD -7·69, 95% CI: -10·12 to -5·26). Spironolactone appeared to be as effective as flutamide (two studies) and finasteride (two studies). However, finasteride and the gonadotropin-releasing analogues showed discrepant results in several RCTs. Metformin was ineffective. Cyproterone acetate combined with OCPs demonstrated greater reductions in Ferriman-Gallwey scores. Lifestyle interventions reduced body mass index but did not show improvement in hirsutism, and although cosmetic measures are frequently used, no RCTs investigating cosmetic treatments were identified. RCTs investigating OCPs in combination with antiandrogens or finasteride vs. OCP alone, or the different antiandrogens and 5α-reductase inhibitors are warranted.

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“…46 Simvastatin treatment, moreover, improved lipid profile and decreased systemic inflammation, body mass index (BMI), fasting insulin levels, and DHEAS. 49 Decreasing DHEAS, an androgen primarily of adrenal production, has been observed in some 50 but not all trials. 46 Interestingly, statins in postmenopausal women, in whom the major source of T is extra-ovarian, had no significant effect on the T level.…”

Section: Human Studiesmentioning

confidence: 99%

Pharmacologic Treatment of Polycystic Ovary Syndrome: Alternate and Future Paths

Duguech

Legro

2017

Semin Reprod Med

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Polycystic ovary syndrome (PCOS) is a complex disorder which interacts with other genetic and environmental factors to cause dysregulation of steroidogenesis and anovulation as well as insulin resistance. Treatments which address the long-term effects of this unique combination of reproductive and metabolic dysfunction are needed. Over the past decade, new insights into the genetic factors of PCOS and biotechnological advances have led to potential treatments for women with PCOS. These treatments include both new potent pharmaceutical compounds and repurposed drugs which target different steps in metabolic-reproductive pathways to improve long-term health of women with PCOS. These new therapies target key enzymes involved in steroidogenesis, regulatory pathways of gonadotropin secretion, or lower oxidative stress. We review in this article the current common treatments of PCOS, recent developments in the field, and current information on the mode of action, efficacy, and safety of emerging therapeutic compounds.

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Atorvastatin therapy decreases androstenedione and dehydroepiandrosterone sulphate concentrations in patients with polycystic ovary syndrome: randomized controlled study

Cited by 29 publications

References 32 publications

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

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

Interventions for hirsutism excluding laser and photoepilation therapy alone: abridged Cochrane systematic review includingGRADEassessments

Pharmacologic Treatment of Polycystic Ovary Syndrome: Alternate and Future Paths

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