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 kgs; 95% CI:- 5.33,-0.93, I²= 5%) and the mean body mass index (BMI) (MD: -0.75 kg/m2; 95% CI: -1.15, -0.36, I²= 0%). There was a significant reduction in the mean BMI with orlistat vs placebo (MD: -1.33 kg/m²; 95% CI: -2.16 -0.66, I²= 0.0%), acarbose vs metformin (MD: -1.26 kg/m²; 95% CI: -2.13, -0.38, I²= 0%), and metformin vs pioglitazone (MD: -0.91 kg/m²; 95% CI: -1.62, -0.19, I²= 0%). A significant increase in the mean BMI was also observed in pioglitazone vs placebo (MD: +2.59 kg/m²; 95% CI: 1.78, 3.38, I²= 0%) and in rosiglitazone vs 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 vs placebo (MD: -1.21 cm; 95% CI: -3.71-1.29, I²= 0%) while a significant increase in the mean WC with pioglitazone vs 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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