Glucagon-like Peptide 1 Receptor Agonists for the Treatment of Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Abstract

Background: Since the Polycystic Ovary Syndrome (PCOS) phenotype might change at different points in a person's life, individualized diagnosis and treatment are required. Since glucagon-like peptide 1 (GLP-1) receptor agonists (RA) improve insulin sensitivity and reduce the risk of cardiovascular disease, they offer a unique opportunity to treat many comorbid diseases and phenotypic aspects of (PCOS) all at once.
 Methods: The PICO framework—which includes the terms "participants," "intervention," "control," and "outcome"—formed the basis for the search parameters. The appropriate research publications were identified by searching many databases, including Web of Sciences, PubMed, Scopus and PRISMA flow chart was constructed. RevMan 5.4 was utilized for the meta-analysis, while RoB-2.0 was employed for quality control.
 Results: After following PRISMA, 14 research articles were included in the present systematic review and meta-analysis. GLP-1 RAs alone or in combination gave good results when compared with control/placebo/other drugs. In the meta-analysis, GLP-1 RA was compared to control (Metformin, a comparative drug, a placebo, and other treatments) for Menestral frequency rate (MFR), Free Androgen Index (FAI), Homeostasis Model Assessment-estimated Insulin Resistance (HOMA-IR), and Total Testosterone (Total T). The results showed that GLP-1 RA had a statistically significant effect on MFR and Total T, indicating that the intervention was more effective than the control group but had no effect on FAI and HOMA-IR, suggesting that both GLP-1 RA and the control group were equally effective. When the quality assessment was done, 7 studies had low risk of bias, and 7 had some concerns, while no study had a high risk of bias.
 Conclusion: GLP-1 RAs may be suitable for obese patients with PCOS, particularly those with insulin resistance. However, as 7 studies had questions about randomization. There has to be more high-quality studies conducted on GLP-1 RAs to determine their effectiveness for PCOS in women.