Context
Polycystic ovary syndrome (PCOS) is a heterogeneous condition affecting women of reproductive age and is associated with increased body weight.
Objective
To review the literature on the effect of different pharmacological interventions on the anthropometric indices in women with PCOS.
Data sources
We searched PubMed, MEDLINE, Scopus, Embase, Cochrane library, and the Web of Science in April 2020 with an update in PubMed in March 2021.
Study selection
The study followed the Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA)2020.
Data extraction
Reviewers extracted data and assessed the risk of bias using the Cochrane risk of bias tool.
Results
80 RCTs were included in the meta‐analysis. Metformin vs placebo showed significant reduction in the mean body weight (MD: −3.13 kg; 95% confidence interval [CI]: −5.33 to −0.93, I² = 5%) and the mean body mass index (BMI) (MD: −0.75 kg/m2; 95% CI: −1.15 to −0.36, I² = 0%). There was a significant reduction in the mean BMI with orlistat versus placebo (MD: −1.33 kg/m²; 95% CI: −2.16 to −0.66, I² = 0.0%), acarbose versus metformin (MD: −1.26 kg/m²; 95% CI: −2.13 to −0.38, I² = 0%), and metformin versus pioglitazone (MD: −0.91 kg/m²; 95% CI: −1.62 to −0.19, I² = 0%). A significant increase in the mean BMI was also observed in pioglitazone versus placebo (MD: + 2.59 kg/m²; 95% CI: 1.78–3.38, I² = 0%) and in rosiglitazone versus metformin (MD: + 0.80 kg/m²; 95% CI: 0.32–1.27, I² = 3%). There was a significant reduction in the mean waist circumference (WC) with metformin versus placebo (MD: −1.21 cm; 95% CI: −3.71 to 1.29, I² = 0%) while a significant increase in the mean WC with pioglitazone versus placebo (MD: + 5.45 cm; 95% CI: 2.18–8.71, I² = 0%).
Conclusion
Pharmacological interventions including metformin, sitagliptin, pioglitazone, rosiglitazone orlistat, and acarbose have significant effects on the anthropometric indices in women with PCOS.