Empagliflozin trims excess weight in overweight, obese women with PCOS
The sodium‐glucose‐cotransporter‐2 (SGLT2) inhibitor empagliflozin yields beneficial effects on weight anthropometric parameters and body composition—including weight, body mass index (BMI), waist and hip circumference, and total body fat—that are greater than those achieved with metformin in overweight and obese women with polycystic ovary syndrome (PCOS), a study has shown.
The study randomized 39 women to receive either empagliflozin 25 mg (n=19; mean age, 26.0 years; mean BMI, 37.1 kg/m2) or metformin 1,500 mg (n=20; mean age, 31.5 years; mean BMI, 38.7 kg/m2) daily for 12 weeks. Outcomes evaluated were changes in anthropometric and body composition, hormonal and metabolic parameters.
By the end of treatment at week 12, empagliflozin produced superior improvements in some of the outcomes compared with metformin: weight (–1.4 percent vs 1.2 percent; p=0.006), BMI (–1.4 percent vs 1.1 percent; p=0.006), waist circumference (–1.6 percent vs 0.2 percent; p=0.029) and hip circumference (–2.0 percent vs 1.1 percent; p=0.001), basal metabolic rate (–1.8 percent vs 0.1 percent; p=0.024) and fat mass (–0.7 percent vs 3.2 percent; p=0.023).
However, there were no significant changes in hormonal or metabolic parameters observed in both treatment groups.
In terms of safety, no adverse events or serious adverse events occurred in the metformin group. On the other hand, two patients on empagliflozin reported headache and dizziness or mild rash, which were unrelated to the study drug.
Despite the encouraging data for empagliflozin, more placebo-controlled and comparative treatment trials of longer-term duration are needed to provide further insights into its effects on PCOS-related outcomes in women with different PCOS phenotypes and related complications (eg, diabetes) before this particular SGLT2 inhibitor gains a therapeutic place in PCOS, researchers said.
Lifestyle interventions involving diet, exercise and behavioural modifications should still be considered the first line of treatment for overweight or obese women with PCOS to reduce body weight, central obesity and insulin resistance, they added.