The role of GLP-1 receptor agonists in obese patients with Polycystic Ovary Syndrome: an integrative review of the literature
DOI:
https://doi.org/10.33448/rsd-v12i9.43306Keywords:
Polycystic Ovary Syndrome; GLP-1 receptor; Liraglutide; Obesity.Abstract
Introduction: Polycystic Ovary Syndrome (PCOS) is associated with ovarian dysfunction, hyperandrogenism and insulin resistance (IR). It is known that obesity is one of the main factors related to the causes of IR, so the treatment of both involves, in association or not with pharmacological options, weight loss measures. Currently, there is no specific medication to treat PCOS and, therefore, the option of using GLP-1 receptor agonists (GLP-1RAs) in this combination corresponds to the objective of the present work. Methodology: This is an integrative review on the use of GLP-1RAs in obese patients with PCOS. Data from the Virtual Health Library (VHL), Scientific Electronic Library Online (SciELO) and National Library of Medicine (PubMed) databases were used, by crossing the descriptors “Polycystic Ovary Syndrome”, “Obesity”, “Treatment”, “Liraglutide” and “GLP-1 receptor agonists”, to answer the question formulated through the PICO strategy. Results and Discussion: PCOS is a condition independent of obesity, but extremely stimulated by it. In the treatment of PCOS, metformin is commonly used, but studies have demonstrated the superiority of GLP-1RAs in reducing BMI, waist circumference and weight, however, regarding menstrual frequency, there are still doubts. Therefore, the association of the two drug options has proven to be beneficial. Conclusion: The association of obesity/IR and PCOS intensifies the disease and the use of GLP-1RAs is mostly beneficial in obese or overweight patients. However, research is needed to find a more effective treatment.
References
Anala, A. D., Sajjad, I., Ibrahim, M., Nanda, M., Naaz, N., & Atkin, S. L. (2023). The Potential Utility of Tirzepatide for the Management of Polycystic Ovary Syndrome. Journal of Clinical Medicine, 12(14), 4575–4575. https://doi.org/10.3390/jcm12144575
Bazzi, A., & Schon, S. (2022). Beyond diet and exercise: another option for patients with obesity and polycystic ovary syndrome? Fertility and Sterility, 118(2), 382–383. https://doi.org/10.1016/j.fertnstert.2022.06.001
Cena, H., Chiovato, L., & Nappi, R. E. (2020). Obesity, Polycystic Ovary Syndrome, and Infertility: A New Avenue for GLP-1 Receptor Agonists. The Journal of Clinical Endocrinology & Metabolism, 105(8), e2695–e2709. https://doi.org/10.1210/clinem/dgaa285
De Souza, T. M., Da Silva, D. M., De Carvalho, R. (2010). Revisão integrativa: o que é e como fazer. Einstein, 8(1). https://doi.org/10.1590/S1679-45082010RW1134
Escobar-Morreale, H. F. (2018). Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nature Reviews Endocrinology, 14(5), 270–284. https://doi.org/10.1038/nrendo.2018.24
Elkind-Hirsch, K. E., Chappell, N., Shaler, D., Storment, J., & Bellanger, D. (2022). Liraglutide 3 mg on weight, body composition, and hormonal and metabolic parameters in women with obesity and polycystic ovary syndrome: a randomized placebo-controlled-phase 3 study. Fertility and Sterility, 118(2), 371–381. https://doi.org/10.1016/j.fertnstert.2022.04.027
Frøssing, S., Nylander, M., Chabanova, E., Frystyk, J., Holst, J. J., Kistorp, C., Skouby, S. O., & Faber, J. (2017). Effect of liraglutide on ectopic fat in polycystic ovary syndrome: A randomized clinical trial. Diabetes, Obesity and Metabolism, 20(1), 215–218. https://doi.org/10.1111/dom.13053
Sindrome dos ovarios policisticos. 3a ed. Sao Paulo: Federacao Brasileira das Associacoes de Ginecologia e Obstetricia – FEBRASGO. (2023). 140p. Serie Orientacoes e Recomendacoes FEBRASGO, n.1, Comissao Nacional de Ginecologia Endocrina.
Glueck, C. J., & Goldenberg, N. (2019). Characteristics of obesity in polycystic ovary syndrome: Etiology, treatment, and genetics. Metabolism, 92, 108–120. https://doi.org/10.1016/j.metabol.2018.11.002
Han, Y., Li, Y., & He, B. (2019). GLP-1 receptor agonists versus metformin in PCOS: a systematic review and meta-analysis. Reproductive BioMedicine Online, 39(2), 332–342. https://doi.org/10.1016/j.rbmo.2019.04.017
Liu, X., Zhang, Y., Zheng, S. Y., Lin, R., Xie, Y. J., Chen, H., Zheng, Y. X., Liu, E., Chen, L., Yan, J. H., Xu, W., Mai, T. T., & Gong, Y. (2017). Efficacy of exenatide on weight loss, metabolic parameters and pregnancy in overweight/obese polycystic ovary syndrome. Clinical endocrinology, 87(6), 767–774. https://doi.org/10.1111/cen.13454
Lyu, X., Lyu, T., Wang, X., Zhu, H., Pan, H., Wang, L., Yang, H., & Gong, F. (2021). The Antiobesity Effect of GLP-1 Receptor Agonists Alone or in Combination with Metformin in Overweight /Obese Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. International Journal of Endocrinology, 2021, 1–11. https://doi.org/10.1155/2021/6616693
Ma, R., Ding, X., Wang, Y., Deng, Y., & Sun, A. (2021). The therapeutic effects of glucagon-like peptide-1 receptor agonists and metformin on polycystic ovary syndrome. Medicine, 100(23), e26295. https://doi.org/10.1097/md.0000000000026295
Nylander, M., Frøssing, S., Clausen, H. V., Kistorp, C., Faber, J., & Skouby, S. O. (2017). Effects of liraglutide on ovarian dysfunction in polycystic ovary syndrome: a randomized clinical trial. Reproductive BioMedicine Online, 35(1), 121–127. https://doi.org/10.1016/j.rbmo.2017.03.023
Papaetis, G. S., Filippou, P. K., Constantinidou, K. G., & Stylianou, C. S. (2020). Liraglutide: New Perspectives for the Treatment of Polycystic Ovary Syndrome. Clinical Drug Investigation, 40(8), 695–713. https://doi.org/10.1007/s40261-020-00942-2
Peeva, M., Badeghiesh, A., Baghlaf, H., & Dahan, M. H. (2022). Association between obesity in women with polycystic ovary syndrome and adverse obstetric outcomes. Reproductive BioMedicine Online, 45(1), 159–167. https://doi.org/10.1016/j.rbmo.2022.02.007
Popoviciu, M. S., Păduraru, L., Yahya, G., Yahya, G., & Cavalu, S. (2023). Emerging Role of GLP-1 Agonists in Obesity: A Comprehensive Review of Randomised Controlled Trials. International Journal of Molecular Sciences, 24(13), 10449–10449. https://doi.org/10.3390/ijms241310449
Sadeghi, H. M., Adeli, I., Calina, D., Docea, A. O., Mousavi, T., Daniali, M., Nikfar, S., Tsatsakis, A., & Abdollahi, M. (2022). Polycystic Ovary Syndrome: A Comprehensive Review of Pathogenesis, Management, and Drug Repurposing. International Journal of Molecular Sciences, 23(2), 583. https://doi.org/10.3390/ijms23020583
Siamashvili, M., & Davis, S. N. (2021). Update on the effects of GLP-1 receptor agonists for the treatment of polycystic ovary syndrome. Expert Review of Clinical Pharmacology, 14(9), 1081–1089. https://doi.org/10.1080/17512433.2021.1933433
Teede, H. J., Tay, C. T., Laven, J. J. E., Dokras, A., Moran, L. J., Piltonen, T. T., Costello, M. F., Boivin, J., Redman, L. M., Boyle, J. A., Norman, R. J., Mousa, A., Joham, A. E., & International PCOS Network (2023). Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. The Journal of clinical endocrinology and metabolism, dgad463. Advance online publication. https://doi.org/10.1210/clinem/dgad463
Zhang, Y., Qu, Z., Lu, T., Shao, X., Cai, M., Dilimulati, D., Gao, X., Mao, W., Hu, F., Su, L., Liao, Q., Han, T., Zhang, M., & Qu, S. (2023). Effects of a Dulaglutide plus Calorie-Restricted Diet versus a Calorie-Restricted Diet on Visceral Fat and Metabolic Profiles in Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial. Nutrients, 15(3), 556. https://doi.org/10.3390/nu15030556
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Copyright (c) 2023 Julia Lais de Sá Gomes; Helena Amédée Péret Motta; Maria Luisa Filogônio Resende Macedo; Júlia Abreu Dorneles ; Sarah Barbosa Leal; Luiza de Oliveira Paculdino; Lunamaris Amaral Soares; Isabella Neves Brito de Araújo ; Bruna Gil Campos; Victor Hugo Martins Paula da Silva
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