Meta-Analysis: Are Anti-Androgens Effective at Treating Symptoms of PCOS?
BACKGROUND AND PURPOSE:
Anti-androgens may help mitigate symptoms of polycystic ovary syndrome (PCOS), but no systematic reviews have synthesized the evidence regarding their efficacy or safety in the PCOS population
Alesi et al. (Lancet eClinicalMedicine, 2023) investigated the efficacy and safety of anti-androgens in the management of hormonal and clinical features of PCOS
Systematic review and meta-analysis
Studies that examined oral anti-androgen use (alone or in combination with metformin, combined oral contraceptive pills (OCPs), lifestyle, or other interventions) in women of any age with PCOS who were also using a form of contraception
Risk of bias was assessed using GRADE criteria
Random effects models were used for meta-analyses
Weight | BMI | Irregular cycles | Hirsutism | Liver function | Quality of life
20 studies (13 were used in the meta-analysis) | 961 total women
High risk of bias: 7 studies | Moderate: 9 | Low: 4
There were no differences in hirsutism when anti-androgens + metformin + lifestyle were compared with either
Anti-androgens + lifestyle
Metformin + lifestyle
In limited meta-analyses (n = 2 trials), combining anti-androgens with OCPs resulted in poorer lipid profiles compared with OCPs ± placebo
There were no differences in other outcomes with this comparison
Anti-androgens are not a better treatment option than OCPs for PCOS
Anti-androgens could be considered as a treatment option for hirsutism associated with PCOS if OCPs or cosmetic therapies (e.g., mechanical laser or light therapies for hair reduction) are contraindicated, poorly tolerated, or don’t work as well as expected after 6 months of use
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan