The reproductive and metabolic effect of rosiglitazone on Chinese women with polycystic ovarian syndrome—a double-blind randomized placebo-controlled study

Lam, Paul; Tam, Wing Hung; Ma, Rong; Cheung, Lai Ping; Tsui, Michelle Hang Yuet; Tong, Peter C.Y.; Chow, Francis Chun Chung; Lam, Christopher Wai Kei; Chan, Michael Ho Ming; Chan, Juliana C.N.; Haines, Christopher J.

doi:10.1016/j.fertnstert.2011.05.085

Cited by 11 publications

(12 citation statements)

References 22 publications

(17 reference statements)

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“…In this prospective, randomized, controlled study, we assessed the effects of different insulin sensitizers and lifestyle modifications on the clinical and endocrine-metabolic profiles of obese, insulin-resistant women with PCOS. As expected, the two types of insulin sensitizers not only improved the metabolic profiles but also recovered the menstrual pattern and lessened hyperandrogenism, with results consistent with previous reports (15,17,27). The anthropometric parameters such as weight, BMI, waist circumference, and WHR statistically significantly decreased in the three study groups; the remarkable decrease in BMI observed with the administration of rosiglitazone alone differed from that in previous reports (28,29).…”

Section: Discussionsupporting

confidence: 89%

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Comparing the individual effects of metformin and rosiglitazone and their combination in obese women with polycystic ovary syndrome: a randomized controlled trial

Tan

Wang

et al. 2020

Fertility and Sterility

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Objective: To compare the effects of metformin, rosiglitazone, and their combination in obese polycystic ovary syndrome (PCOS) patients with insulin resistance. Design: Prospective randomized controlled trail. Setting: Tertiary teaching hospital. Patient(s): Obese Chinese women (body mass index [BMI] R25 kg/m 2 ) with insulin resistance who fulfilled the Rotterdam criteria of PCOS. Intervention(s): In group 1, 68 patients administered metformin (1,500 mg/day); in group 2, 67 patients administered rosiglitazone (4 mg/day); in group 3, 69 patients administered metformin (1,000 mg/day) and rosiglitazone (4 mg/day) for 6 months, all with the same diet and regular exercise lifestyle recommendation. Main Outcome Measure(s): Average menstrual interval, anthropometric measurements, androgen-related parameters, and metabolic features of insulin, carbohydrates, and lipids, with intention-to-treat analysis. Result(s): The baseline parameters showed no statistically significant differences. After the 6-month treatment, most participants showed an improved menstrual pattern. There were statistically significant decreases in acne scores, weight, BMI, waist circumference, waist-to-hip ratio, and serum testosterone. The metabolic indexes of insulin, carbohydrates, and lipids were improved obviously compared with the baseline in each group. Among the three groups, the patients administered 1,500 mg/day metformin experienced greater reductions in weight. However, the rosiglitazone users (alone or combined with metformin) showed a more notable decline in total cholesterol and triglyceride levels. Conclusion(s):Considering the benefits of metformin on weight loss, high-dose metformin (1,500 mg/day) along with lifestyle modification should be recommended for obese, insulin-resistant women with PCOS. Rosiglitazone alone or combined with lowdosage metformin plus lifestyle modification should be considered for the women with abnormal lipid profiles.

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Section: Discussionsupporting

confidence: 89%

“…Rosiglitazone, a peroxisome proliferator-activated receptor-g (PPAR-g) agonist, has been widely used to treat non-insulin-dependent diabetes. Though studies have shown that rosiglitazone may ameliorate insulin resistance, hyperandrogenemia, menstrual disturbances, and ovulation (15,16), the quality and certainty of the evidence have been limited.…”

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confidence: 99%

Comparing the individual effects of metformin and rosiglitazone and their combination in obese women with polycystic ovary syndrome: a randomized controlled trial

Tan

Wang

et al. 2020

Fertility and Sterility

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“…The 80 RCTs were published between 2000 and 2020 and included (4028 participants both PCOS and control) that met the inclusion criteria and were included in the meta‐analysis. Forty‐two trials 20–61 diagnosed PCOS based on the Rotterdam 2003 criteria, 62 10 trials 35,63–72 used the National Institute of Health 1990 (NIH, NICHD) criteria, one trial 73 used the Androgen Excess Society 2006 (AES) criteria, 74 and no diagnostic criteria were specified for the remainder of the trials (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Impact of pharmacological interventions on anthropometric indices in women with polycystic ovary syndrome: A systematic review and meta‐analysis of randomized controlled trials

Abdalla

Shah

Deshmukh

et al. 2022

Clinical Endocrinology

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Context Polycystic ovary syndrome (PCOS) is a heterogeneous condition affecting women of reproductive age and is associated with increased body weight. Objective To review the literature on the effect of different pharmacological interventions on the anthropometric indices in women with PCOS. Data sources We searched PubMed, MEDLINE, Scopus, Embase, Cochrane library, and the Web of Science in April 2020 with an update in PubMed in March 2021. Study selection The study followed the Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA)2020. Data extraction Reviewers extracted data and assessed the risk of bias using the Cochrane risk of bias tool. Results 80 RCTs were included in the meta‐analysis. Metformin vs placebo showed significant reduction in the mean body weight (MD: −3.13 kg; 95% confidence interval [CI]: −5.33 to −0.93, I² = 5%) and the mean body mass index (BMI) (MD: −0.75 kg/m2; 95% CI: −1.15 to −0.36, I² = 0%). There was a significant reduction in the mean BMI with orlistat versus placebo (MD: −1.33 kg/m²; 95% CI: −2.16 to −0.66, I² = 0.0%), acarbose versus metformin (MD: −1.26 kg/m²; 95% CI: −2.13 to −0.38, I² = 0%), and metformin versus pioglitazone (MD: −0.91 kg/m²; 95% CI: −1.62 to −0.19, I² = 0%). A significant increase in the mean BMI was also observed in pioglitazone versus placebo (MD: + 2.59 kg/m²; 95% CI: 1.78–3.38, I² = 0%) and in rosiglitazone versus metformin (MD: + 0.80 kg/m²; 95% CI: 0.32–1.27, I² = 3%). There was a significant reduction in the mean waist circumference (WC) with metformin versus placebo (MD: −1.21 cm; 95% CI: −3.71 to 1.29, I² = 0%) while a significant increase in the mean WC with pioglitazone versus placebo (MD: + 5.45 cm; 95% CI: 2.18–8.71, I² = 0%). Conclusion Pharmacological interventions including metformin, sitagliptin, pioglitazone, rosiglitazone orlistat, and acarbose have significant effects on the anthropometric indices in women with PCOS.

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“…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%

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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The reproductive and metabolic effect of rosiglitazone on Chinese women with polycystic ovarian syndrome—a double-blind randomized placebo-controlled study

Cited by 11 publications

References 22 publications

Comparing the individual effects of metformin and rosiglitazone and their combination in obese women with polycystic ovary syndrome: a randomized controlled trial

Comparing the individual effects of metformin and rosiglitazone and their combination in obese women with polycystic ovary syndrome: a randomized controlled trial

Impact of pharmacological interventions on anthropometric indices in women with polycystic ovary syndrome: A systematic review and meta‐analysis of randomized controlled trials

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

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