Impact of pharmacological interventions on anthropometric indices in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials

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.