Clinical question: What is the role of glucagon-like peptide-1 (GLP-1) analogs in polycystic ovary syndrome (PCOS)?
Background: GLP-1 analogs have been shown to improve outcomes in a variety of other metabolic conditions and now are being expanded to use in PCOS.
Study design: Review article
Setting: Article review on international data on GLP-1 use in PCOS patients
Synopsis: GLP-1s have been investigated in PCOS patients for a variety of outcomes. While we know their benefits in weight loss, GLP-1s have been found to have other independent properties that contribute to a reduction in insulin resistance, including in this population. Notably, one study highlighted that pre-diabetes remission was superior in patients on a GLP-1 and metformin and better in those on GLP-1 monotherapy when compared to metformin alone. It was also found to potentially reduce metabolic-dysfunction-associated fatty liver disease in PCOS patients and improve fertility, though further data on GLP-1 safety in pregnancy is still needed. While the paper does an excellent job reviewing articles, it does not mention its article retrieval process, nor what definition of PCOS it required for article consideration.
Bottom line: GLP-1s can provide a variety of benefits in PCOS patients as a monotherapy or in addition to metformin. Further investigation, particularly into safety in pregnancy, is warranted given possible fertility benefits.
Citation: Szczesnowicz A, Szeliga A, et al. Do GLP-1 analogs have a place in the treatment of PCOS? New insights and promising therapies. J Clin Med. 2023;12(18):5915.
Dr. Knoll
Dr. Knoll is a hospitalist in the division of hospital medicine at NYU Langone Tisch Hospital and an assistant professor of medicine at the NYU Grossman School of Medicine, both in New York.