Liraglutide: New Perspectives for the Treatment of Polycystic Ovary Syndrome

• Published in: Clinical drug investigation 2020-08, Vol.40 (8), p.695-713
• Main Authors: Papaetis, Georgios S., Filippou, Panagiota K., Constantinidou, Kiriaki G., Stylianou, Christina S.
• Format: Article
• Language: English
• Subjects: Abdomen; Adrenal glands; Androgens; Antidiabetics; Diabetes; Enzymes; Genotype & phenotype; GLP-1 receptor agonists; Glucagon; Glucose; Insulin resistance; Internal Medicine; Medicine; Medicine & Public Health; Metabolism; Morphology; Obesity; Ovaries; Overweight; Ovulation; Pharmacology/Toxicology; Pharmacotherapy; Polycystic ovary syndrome; Polypeptides; Review Article; Testosterone; Weight control; Womens health
• ISSN: 1173-2563; 1179-1918
• DOI: 10.1007/s40261-020-00942-2

Polycystic ovary syndrome is a complex and heterogenous disorder involving multiple organ systems and different molecular pathways. It is tightly associated with obesity and especially abdominal obesity. As body weight reduction is the main modifiable risk factor for polycystic ovary syndrome, therapeutic approaches in overweight or obese women with polycystic ovary syndrome have been developed. Liraglutide is a glucagon-like peptide-1 receptor agonist that promotes sustained weight loss, as well as abdominal fat reduction, in individuals with obesity, prediabetes, and type 2 diabetes mellitus. The majority of current clinical studies have demonstrated that liraglutide therapy achieved significant reductions in body weight, body mass index, and abdominal circumference in overweight and obese women with polycystic ovary syndrome. Liraglutide therapy promoted significant improvements in free testosterone and sex hormone-binding globulin levels in some studies. Important metabolic and hormonal improvements were also reported after the combination of liraglutide with metformin. Increased menstrual frequency, as well as potential positive effects in reproduction, were described. However, the small number of participants, short duration, and low daily liraglutide dose are some of the main limitations of these studies. Larger and longer, multi-centred, double-blind, placebo-controlled trials of liraglutide monotherapy or combination therapy, with prolonged post-interventional monitoring, are crucially anticipated. Metabolic, hormonal, and reproductive primary outcomes should be uniformly addressed, to tailor future targeted treatment approaches, according to the patient phenotype and needs. This will improve long-term therapeutic outcomes in this population.