Empagliflozin treatment tied to improved metabolic profile in polycystic ovary syndrome

  • Javed Z & al.
  • Clin Endocrinol (Oxf)
  • 13 Mar 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In overweight and obese women with polycystic ovary syndrome (PCOS), empagliflozin treatment over a 12-week period is associated with significant reduction in weight, body mass index (BMI), waist and hip circumference, and total body fat compared with metformin.
  • No effects were observed on hormonal and metabolic parameters, including insulin resistance and androgen levels.

Why this matters

  • Findings provide further insights into the effects of empagliflozin on PCOS-related outcomes in women with PCOS with different PCOS phenotypes and PCOS-related complications.

Study design

  • This randomised open-label study randomly assigned 39 women with PCOS (age, 18-45 years) to receive empagliflozin 25 mg (n=19) and metformin 1500 mg (n=20) daily for 12 weeks.
  • Main outcomes: changes in anthropometric, body composition, hormonal and metabolic parameters.
  • Funding: Academic Diabetes Endocrinology and Metabolism Unit at University of Hull.

Key results

  • Univariant analysis showed that empagliflozin vs metformin showed significant reduction in:
    • weight (-1.4±3.2% vs 1.2±2.3%; P=.006),
    • BMI (-1.4±3.2% vs 1.1±2.2%; P=.007),
    • waist (-1.6±2.8% vs 0.2±2.1%; P=.029) and hip (-2.0±3.0% vs 1.1±1.9%; P=.001) circumference,
    • basal metabolic rate (-1.8±2.9% vs 0.1±1.9%; P=.024), and
    • body fat mass (-0.7±4.9% vs 3.2±5.0%; P=.023).
  • Empagliflozin treatment showed significant increases in sex hormone binding globulin (P=.049) and oestradiol levels (P=0.032) after 12 weeks.
  • No significant differences were seen in blood pressure, endothelial function, insulin sensitivity, fasting lipid profile or hs-CRP were observed between both the groups.

Limitations

  • Study did not assess the effects of metformin on hormonal parameters because of short follow-up period.