Short term monotherapy with exenatide is superior to metformin in weight loss, improving insulin resistance and inflammation in Chinese overweight/obese PCOS women

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AimsTo evaluate the efficacy of exenatide on weight loss, insulin resistance, menstrual periods, metabolic profiles, inflammatory markers, and safety compared with metformin in Chinese overweight/obese patients with polycystic ovary syndrome. MethodsEighty-two overweight/obese (OW/OB) patients with PCOS were randomly assigned to the exenatide group (10 μg BID sc, n = 41) or metformin group (1000 mg BID po, n = 41) for 12 weeks. The main primary outcomes was mean change in body weight. ResultsSixty-three patients completed the study (31 cases in the EXE group and 32 cases in the MET group). EXE treatment was superior to MET treatment in weight loss (P = 0.009), with EXE leading to a significant mean loss of 3.1 ± 0.2 kg (P < 0.001) and MET leading to a significant mean loss of 1.2 ± 0.3 kg (P < 0.001). There was a significantly greater effect of EXE compared to metformin with respect to 2hINS, HOMA-IR, INSAUC and ISI (P < 0.001, P = 0.004, P < 0.001, P < 0.021, respectively), with both treatments leading to significant decreases in 2hINS, HOMA-IR and INSAUC (P < 0.001, P < 0.001, P < 0.001, respectively); and a significant increase in ISI (P < 0.001). FAI decreased while SHBG increased significantly with both treatments (P = 0.022, P < 0.001, respectively) with no significant difference between two groups (P > 0.05). EXE treatment was superior to MET treatment in reducing hsCRP (P = 0.016) with both treatments leading to a significant increase (P < 0.001). Menstrual periods, mFG score and Rosenfield score were not significantly different before and after treatment for either group (P > 0.05). ConclusionsShort-term exenatide treatment possesses a greater efficacy in terms of weight loss, improving insulin resistance and reducing inflammation than metformin. Large-sample and long-term clinical trials, however, are needed to assess exenatide's efficacy and safety in OW/OB women with PCOS.