Short-term combined treatment with exenatide and metformin for overweight/obese women with polycystic ovary syndrome

• Published in: Chinese medical journal 2021-11, Vol.134 (23), p.2882-2889
• Main Authors: Ma, Rui-Lin, Deng, Yan, Wang, Yan-Fang, Zhu, Shi-Yang, Ding, Xue-Song, Sun, Ai-Jun
• Format: Article
• Language: English
• Subjects: Androgens; Antidiabetics; Apolipoproteins; Automation; Body mass index; Cholesterol; Clinical trials; Diabetes; Drug dosages; Drug withdrawal; Exenatide - therapeutic use; Female; GLP-1 receptor agonists; Glucose; Homeostasis; Humans; Immunoassay; Insulin resistance; Laboratories; Menstruation; Metabolism; Metformin - therapeutic use; Obesity; Obesity - drug therapy; Original; Ovaries; Overweight; Patients; Polycystic ovary syndrome; Polycystic Ovary Syndrome - drug therapy; Proteins; Weight control; Womens health
• ISSN: 0366-6999; 2542-5641
• DOI: 10.1097/CM9.0000000000001712

Obesity and insulin resistance (IR) are common features of polycystic ovary syndrome (PCOS). Metformin (MET) increases insulin sensitivity, but it is associated with unsatisfactory weight loss. The glucagon-like peptide-1 receptor agonist exenatide has been shown to reduce weight and IR in patients with diabetes. This study aimed to explore the therapeutic effects of exenatide once-weekly (QW) combined with MET on body weight, as well as metabolic and endocrinological parameters in overweight/obese women with PCOS. Fifty overweight/obese women with PCOS diagnosed via the Rotterdam criteria were randomized to one of two treatment groups: MET (500 mg three times a day [TID]) or combination treatment (COM) (MET 500 mg TID, exenatide 2 mg QW) for 12 weeks. The primary outcomes were anthropometric changes associated with obesity, and the secondary outcomes included changes in reproductive hormone levels, glucose and lipid metabolism, and C-reactive protein. Forty (80%) patients completed the study. COM therapy was superior to MET monotherapy in reducing weight (P = 0.045), body mass index (BMI) (P = 0.041), and waist circumference (P = 0.023). Patients in the COM group on an average lost 3.8 ± 2.4 kg compared with 2.1 ± 3.0 kg in the MET group. In the COM group, BMI and waist circumference decreased by 1.4 ± 0.87 kg/m2 and 4.63 ± 4.42 cm compared with 0.77 ± 1.17 kg/m2 and 1.72 ± 3.07 cm in the MET group, respectively. Moreover, levels of fasting glucose, oral glucose tolerance test (OGTT) 2-h glucose, and OGTT 2-h insulin were significantly lower with COM therapy than with MET (P