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Journal of Education, Health and Sport

How do new therapeutic strategies for PCOS management influence the health of the affected individuals? The narrative review
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  • How do new therapeutic strategies for PCOS management influence the health of the affected individuals? The narrative review
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How do new therapeutic strategies for PCOS management influence the health of the affected individuals? The narrative review

Authors

  • Aleksandra Wójcik Uniwersytet Medyczny w Lublinie https://orcid.org/0000-0003-1669-7466
  • Jan Wojtas Uniwersytet Medyczny w Lublinie https://orcid.org/0000-0003-1393-3689
  • Mikołaj Margas Uniwersytet Medyczny w Lublinie https://orcid.org/0000-0002-7420-0190
  • Konrad Warchoł Uniwersytet Medyczny w Lublinie https://orcid.org/0000-0001-9467-680X
  • Karol Stępniak Uniwersytet Medyczny w Lublinie https://orcid.org/0000-0002-8134-7967

DOI:

https://doi.org/10.12775/JEHS.2022.12.10.035

Keywords

policystic ovary syndrome, gonadal disorders, inositol, berberine, glucagon-like peptide-1, thiazolidinediones

Abstract

Introduction and purpose: Management of polycystic ovary syndrome (PCOS) is difficult since the exact pathogenic mechanism has not been established yet. Due to that fact, the substances registered to treat PCOS are still lacking efficacy and are associated with a number of adverse effects. The aim of this study is to review new possible treatment approaches.

 

State of knowledge: Inositol administered alone or combined with oral contraceptive drugs improves patients’ hormonal status and alleviates the weight increase in comparison to oral contraceptive drugs on their own. Berberine reduces insulin resistance, improves lipid metabolism, and reduces inflammatory reactions. Glucagon-like peptide-1 receptor agonists have a better weight loss effect and less severe adverse reactions than metformin. Thiazolidinediones combined with metformin improve ovulation rate, acne and increase SHGB levels. Thiazolidinediones have also less severe adverse reactions than metformin and can be useful in patients who are not able to tolerate metformin.

 

Summary: The review has shown that inositol, berberine, glucagon-like peptide-1 receptor agonists andthiazolidinediones have promising therapeutic effects in terms of PCOS treatment, however, more research is needed to establish safety and efficacy of those agents. Nonetheless, results of this study may be utilized in the education of health specialists in endocrinology departments.

References

Witchel SF, Oberfield SE, Peña AS. Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls. J Endocr Soc. 2019;3(8):1545-1573. doi:10.1210/js.2019-00078

Krysiak R, Okopień B, Gdula-Dymek A, Herman ZS. Update on the management of polycystic ovary syndrome. Pharmacol Rep PR. 2006;58(5):614-625.

Franks S. Polycystic Ovary Syndrome. N Engl J Med. 1995;333(13):853-861. doi:10.1056/NEJM199509283331307

Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nat Rev Endocrinol. 2018;14(5):270-284. doi:10.1038/nrendo.2018.24

Khan MJ, Ullah A, Basit S. Genetic Basis of Polycystic Ovary Syndrome (PCOS): Current Perspectives. Appl Clin Genet. 2019;12:249-260. doi:10.2147/TACG.S200341

Yau H, Rivera K, Lomonaco R, Cusi K. The future of thiazolidinedione therapy in the management of type 2 diabetes mellitus. Curr Diab Rep. 2013;13(3):329-341. doi:10.1007/s11892-013-0378-8

Xu Y, Wu Y, Huang Q. Comparison of the effect between pioglitazone and metformin in treating patients with PCOS:a meta-analysis. Arch Gynecol Obstet. 2017;296(4):661-677. doi:10.1007/s00404-017-4480-z

Balen A. The pathophysiology of polycystic ovary syndrome: trying to understand PCOS and its endocrinology. Best Pract Res Clin Obstet Gynaecol. 2004;18(5):685-706. doi:10.1016/j.bpobgyn.2004.05.004

Ibáñez L, Oberfield SE, Witchel S, et al. An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence. Horm Res Paediatr. 2017;88:371-395. doi:10.1159/000479371

Rojas J, Chávez M, Olivar L, et al. Polycystic Ovary Syndrome, Insulin Resistance, and Obesity: Navigating the Pathophysiologic Labyrinth. Int J Reprod Med. 2014;2014:719050. doi:10.1155/2014/719050

Bhide P, Homburg R. Anti-Müllerian hormone and polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol. 2016;37:38-45. doi:10.1016/j.bpobgyn.2016.03.004

International evidence- based guideline for the assessment and management of polycystic ovary syndrome. Copyright Monash University, Melbourne Australia 2018.

Bizzarri M, Carlomagno G. Inositol: history of an effective therapy for Polycystic Ovary Syndrome. Eur Rev Med Pharmacol Sci. 2014;18(13):1896-1903.

Chhetri DR. Myo-Inositol and Its Derivatives: Their Emerging Role in the Treatment of Human Diseases. Front Pharmacol. 2019;10:1172. doi:10.3389/fphar.2019.01172

Urrila AS, Hakkarainen A, Castaneda A, Paunio T, Marttunen M, Lundbom N. Frontal Cortex Myo-Inositol Is Associated with Sleep and Depression in Adolescents: A Proton Magnetic Resonance Spectroscopy Study. Neuropsychobiology. 2017;75(1):21-31. doi:10.1159/000478861

Gambioli R, Forte G, Aragona C, Bevilacqua A, Bizzarri M, Unfer V. The use of D-chiro-Inositol in clinical practice. Eur Rev Med Pharmacol Sci. 2021;25(1):438-446. doi:10.26355/eurrev_202101_24412

Pkhaladze L, Russo M, Unfer V, Nordio M, Basciani S, Khomasuridze A. Treatment of lean PCOS teenagers: a follow-up comparison between Myo-Inositol and oral contraceptives. Eur Rev Med Pharmacol Sci. 2021;25(23):7476-7485. doi:10.26355/eurrev_202112_27447

Regidor PA, Schindler AE, Lesoine B, Druckman R. Management of women with PCOS using myo-inositol and folic acid. New clinical data and review of the literature. Horm Mol Biol Clin Investig. 2018;34(2):/j/hmbci.2018.34.issue-2/hmbci-2017-0067/hmbci-2017-0067.xml. doi:10.1515/hmbci-2017-0067

Jamilian M, Farhat P, Foroozanfard F, et al. Comparison of myo-inositol and metformin on clinical, metabolic and genetic parameters in polycystic ovary syndrome: A randomized controlled clinical trial. Clin Endocrinol (Oxf). 2017;87(2):194-200. doi:10.1111/cen.13366

Jamilian H, Jamilian M, Foroozanfard F, Afshar Ebrahimi F, Bahmani F, Asemi Z. Comparison of myo-inositol and metformin on mental health parameters and biomarkers of oxidative stress in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. J Psychosom Obstet Gynaecol. 2018;39(4):307-314. doi:10.1080/0167482X.2017.1383381

Minozzi M, Nordio M, Pajalich R. The Combined therapy myo-inositol plus D-Chiro-inositol, in a physiological ratio, reduces the cardiovascular risk by improving the lipid profile in PCOS patients. Eur Rev Med Pharmacol Sci. 2013;17(4):537-540.

Nordio M, Basciani S, Camajani E. The 40:1 myo-inositol/D-chiro-inositol plasma ratio is able to restore ovulation in PCOS patients: comparison with other ratios. Eur Rev Med Pharmacol Sci. 2019;23(12):5512-5521. doi:10.26355/eurrev_201906_18223

Carlomagno G, Unfer V. Inositol safety: clinical evidences. Eur Rev Med Pharmacol Sci. 2011;15(8):931-936.

Wang K, Feng X, Chai L, Cao S, Qiu F. The metabolism of berberine and its contribution to the pharmacological effects. Drug Metab Rev. 2017;49(2):139-157. doi:10.1080/03602532.2017.1306544

Yin J, Xing H, Ye J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism. 2008;57(5):712-717. doi:10.1016/j.metabol.2008.01.013

Yan HM, Xia MF, Wang Y, et al. Efficacy of Berberine in Patients with Non-Alcoholic Fatty Liver Disease. PLoS ONE. 2015;10(8):e0134172. doi:10.1371/journal.pone.0134172

Zhang SW, Zhou J, Gober HJ, Leung WT, Wang L. Effect and mechanism of berberine against polycystic ovary syndrome. Biomed Pharmacother Biomedecine Pharmacother. 2021;138:111468. doi:10.1016/j.biopha.2021.111468

Wei W, Zhao H, Wang A, et al. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. 2012;166(1):99-105. doi:10.1530/EJE-11-0616

Rehman K, Akash MSH, Liaqat A, Kamal S, Qadir MI, Rasul A. Role of Interleukin-6 in Development of Insulin Resistance and Type 2 Diabetes Mellitus. Crit Rev Eukaryot Gene Expr. 2017;27(3):229-236. doi:10.1615/CritRevEukaryotGeneExpr.2017019712

Kuang H, Duan Y, Li D, et al. The role of serum inflammatory cytokines and berberine in the insulin signaling pathway among women with polycystic ovary syndrome. PLoS ONE. 2020;15(8):e0235404. doi:10.1371/journal.pone.0235404

Rondanelli M, Infantino V, Riva A, et al. Polycystic ovary syndrome management: a review of the possible amazing role of berberine. Arch Gynecol Obstet. 2020;301(1):53-60. doi:10.1007/s00404-020-05450-4

Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69-81. doi:10.1016/j.jep.2014.09.049

Andersen A, Lund A, Knop FK, Vilsbøll T. Glucagon-like peptide 1 in health and disease. Nat Rev Endocrinol. 2018;14(7):390-403. doi:10.1038/s41574-018-0016-2

Ma R, Ding X, Wang Y, Deng Y, Sun A. The therapeutic effects of glucagon-like peptide-1 receptor agonists and metformin on polycystic ovary syndrome. Medicine (Baltimore). 2021;100(23):e26295. doi:10.1097/MD.0000000000026295

Sfairopoulos D, Liatis S, Tigas S, Liberopoulos E. Clinical pharmacology of glucagon-like peptide-1 receptor agonists. Horm Athens Greece. 2018;17(3):333-350. doi:10.1007/s42000-018-0038-0

Han Y, Li Y, He B. GLP-1 receptor agonists versus metformin in PCOS: a systematic review and meta-analysis. Reprod Biomed Online. 2019;39(2):332-342. doi:10.1016/j.rbmo.2019.04.017

Jensterle M, Kravos NA, Goričar K, Janez A. Short-term effectiveness of low dose liraglutide in combination with metformin versus high dose liraglutide alone in treatment of obese PCOS: randomized trial. BMC Endocr Disord. 2017;17(1):5. doi:10.1186/s12902-017-0155-9

Marso SP, Bain SC, Consoli A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016;375(19):1834-1844. doi:10.1056/NEJMoa1607141

Elkind-Hirsch K, Marrioneaux O, Bhushan M, Vernor D, Bhushan R. Comparison of single and combined treatment with exenatide and metformin on menstrual cyclicity in overweight women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2008;93(7):2670-2678. doi:10.1210/jc.2008-0115

Dawson AJ, Sathyapalan T, Vince R, et al. The Effect of Exenatide on Cardiovascular Risk Markers in Women With Polycystic Ovary Syndrome. Front Endocrinol. 2019;10:189. doi:10.3389/fendo.2019.00189

Eggleton JS, Jialal I. Thiazolidinediones. In: StatPearls. StatPearls Publishing; 2022. Accessed September 12, 2022. http://www.ncbi.nlm.nih.gov/books/NBK551656/

Glintborg D. Endocrine and metabolic characteristics in polycystic ovary syndrome. Dan Med J. 2016;63(4):B5232.

Xing C, Li C, He B. Insulin Sensitizers for Improving the Endocrine and Metabolic Profile in Overweight Women With PCOS. J Clin Endocrinol Metab. 2020;105(9):dgaa337. doi:10.1210/clinem/dgaa337

Guo QJ, Shan J, Xu YF, et al. Pioglitazone Metformin Complex Improves Polycystic Ovary Syndrome Comorbid Psychological Distress via Inhibiting NLRP3 Inflammasome Activation: A Prospective Clinical Study. Mediators Inflamm. 2020;2020:3050487. doi:10.1155/2020/3050487

Wooltorton E. Diane-35 (cyproterone acetate): safety concerns. CMAJ Can Med Assoc J. 2003;168(4):455-456.

Cao C, Qi Y, Fang D, Yu Y. Clinical study on polycystic ovary syndrome treated with Diane-35 and Pioglitazone. Am J Transl Res. 2021;13(11):12742-12749.

Lauretta R, Lanzolla G, Vici P, Mariani L, Moretti C, Appetecchia M. Insulin-Sensitizers, Polycystic Ovary Syndrome and Gynaecological Cancer Risk. Int J Endocrinol. 2016;2016:8671762. doi:10.1155/2016/8671762

Shahebrahimi K, Jalilian N, Bazgir N, Rezaei M. Comparison clinical and metabolic effects of metformin and pioglitazone in polycystic ovary syndrome. Indian J Endocrinol Metab. 2016;20(6):805-809. doi:10.4103/2230-8210.192925

Morley LC, Tang T, Yasmin E, Norman RJ, Balen AH. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Cochrane Database Syst Rev. 2017;11:CD003053. doi:10.1002/14651858.CD003053.pub6

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Published

2022-10-31

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WÓJCIK, Aleksandra, WOJTAS, Jan, MARGAS, Mikołaj, WARCHOŁ, Konrad & STĘPNIAK, Karol. How do new therapeutic strategies for PCOS management influence the health of the affected individuals? The narrative review. Journal of Education, Health and Sport [online]. 31 October 2022, T. 12, nr 10, s. 294–300. [accessed 31.3.2023]. DOI 10.12775/JEHS.2022.12.10.035.
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Vol. 12 No. 10 (2022)

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Review Articles

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Copyright (c) 2022 Aleksandra Wójcik, Jan Wojtas, Mikołaj Margas, Konrad Warchoł, Karol Stępniak

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