GLP-1 receptor agonist treatment in women with polycystic ovary syndrome-a systematic review and meta-analysis.

OBJECTIVE

To assess the effect of treatment with glucagon-like peptide-1 receptor agonists (GLP1-RAs) on weight-related, metabolic, and reproductive outcomes and health economics in women with polycystic ovary syndrome (PCOS).

DESIGN

Systematic review and meta-analysis, Prospero CRD42024535096.

METHODS

Cochrane Library, EMBASE, and Medline were searched on September 20, 2024 for studies including women with PCOS, comparing GLP1-RAs with no treatment, placebo, lifestyle intervention, combined oral contraceptives, antiandrogenic drugs, or metformin in randomized controlled trials (RCTs).

RESULTS

A total of 9654 studies were identified, 365 read in full text and 11 RCTs were included. GLP1-RAs as an add-on showed a reduction in BMI compared to the control group, mean difference (95% CI), -1.38 (-2.39 to -0.38) kg/m2 (low certainty). For LDL cholesterol and triglycerides, no difference was noted between the groups (low certainty), whereas evidence was insufficient to draw conclusion regarding glucose, insulin, hirsutism, and menstrual regularity. No studies were identified assessing quality of life, mental health, or cost-effectiveness outcomes.

CONCLUSION

GLP-1-RAs are associated with modest short-term weight loss in women with PCOS and overweight or obesity. Evidence for benefits on metabolic, reproductive, or psychological outcomes remains uncertain due to low-quality data, and no studies have evaluated cost-effectiveness.

TRIAL REGISTRATION: The protocol for the systematic review was registered prospectively in Prospero, CRD42024535096.