Exenatide improves chances of pregnancy in PCOS than does metformin
Short-term treatment with exenatide yields significant weight loss and central adiposity reduction, which appear to explain further improvements in insulin resistance, inflammatory marker and menstrual cycle in overweight or obese women with polycystic ovary syndrome (PCOS), a study has shown.
The 24-week study randomized 176 female overweight or obese PCOS patients to receive either exenatide 10 μg twice daily (n=88) or metformin 1,000 mg twice daily (n=88) for the first 12 weeks. All patients were treated with metformin alone during the second 12 weeks.
The main outcome measure was change in weight, and secondary outcome measures included alterations in fat mass, hormonal levels, insulin resistance, lipid profiles, inflammatory marker, menstrual frequency and rate of pregnancy. Metabolic parameters were evaluated at baseline and at 12 weeks, with the rate of pregnancy tracked during the second 12 weeks.
Compared with metformin, exenatide yielded significant reductions in weight (4.29 vs 2.28 kg; p<0.001) and total fat percentage (4.67 vs 1.11 percent; p<0.001), as well as marked improvements in the homeostasis model of assessment for insulin resistance (1.30 vs 0.59; p<0.001) and the menstrual frequency ratio (0.62 vs 0.37; p<0.001) during the first 12 weeks of intervention.
During the second 12 weeks, the rate of natural pregnancy was significantly higher in exenatide-treated than in metformin-treated patients (43.6 vs 18.7 percent; p<0.05).
The present data provide evidence of greater increases in the chance of pregnancy with exenatide than with metformin in PCOS patients who are overweight or obese, researchers said.
High body mass index negatively affects several aspects of PCOS, particularly infertility. Previous reports indicate insulin excess as the principal factor involved in the association between obesity and fertility-related disorders, with anovulation attributed to increased ovarian androgen production and derangement of early follicle development. [Biomedicine Online 2006;12:542-551; Endocrine Reviews 2015;36:1-24]