A systematic review and meta-analysis of randomized controlled trials comparing pioglitazone versus metformin in the treatment of polycystic ovary syndrome
Abstract
OBJECTIVE: Evidence indicates that metformin and pioglitazone both improve insulin resistance and hirsutism among patient with polycystic ovarian syndrome (PCOS). However, the effectiveness of pioglitazone versus metformin in the treatment of PCOS remains controversial. To summarize the relative efficacy of pioglitazone and metformin in PCOS patients, a systematic review and meta-analysis of randomized controlled trials (RCTs) was performed. METHODS: The authors searched MEDLINE, EMBASE, CNKI and WANFANG DATA for articles published up to November 2011 to identify those comparing pioglitazone versus metformin as a treatment for PCOS. RESULTS: Of the 161 studies retrieved, six trials were included in this analysis, including a total of 278 women with PCOS. Pioglitazone was found to be significantly more effective than metformin at reducing fasting insulin level (P = 0.002, standardized mean differences [SMD] = -0.37, 95% confidence interval [CI] [-0.61, -0.13]). Similarly, pioglitazone was found to be significantly more effective than metformin at improving the HOMA-IR index (P = 0.014, SMD = -0.32, 95% CI [-0.57, -0.06]). However, pioglitazone was significantly less effective than metformin at reducing body mass index (BMI; P = 0.038, SMD = 0.25, 95% CI [0.01, 0.49]). The effect of pioglitazone on fasting glucose levels, testosterone levels, and Ferriman-Gallwey scores was not significantly different from that of metformin (P greater than 0.05 for all). CONCLUSION: This systematic review and meta-analysis suggests that pioglitazone was more suitable for treating hyperinsulinemia and insulin resistance among PCOS patients, while metformin was more effective in reducing body weight. Well designed RCTs are needed to provide better evidence.
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A meta-analysis including five trials comparing pioglitazone versus metformin on 258 patients showed a similar effect of the two drugs on fasting blood glucose levels, with mean difference 0.21 mmol/l (95% CI −0.46 to 0.03; p = 0.089).
“The same group performed another meta-analysis [64] including five trials comparing pioglitazone versus metformin on 258 patients, with fasting glucose levels as an outcome. Results showed a similar effect of the two drugs on FBG levels (MD: 0.21 mmol/l; 95% CI −0.46 to 0.03; p = 0.089).”
From From Prediabetes to Type 2 Diabetes Mellitus in Women with Polycystic Ovary Syndrome: Lifestyle and Pharmacological Management (2020) · cites this paper as [64]
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- Authors
- Du, Q., Wang, Y.-J., Yang, S., Wu, B., Han, P., & Zhao, Y.-Y.
- Affiliations
- Sheng Jing Hospital (CN)
- Department of Endocrinology, Shengjing Hospital of China Medical University Liaoning ProvinceChina
- Library, Shengjing Hospital of China Medical University Liaoning ProvinceChina
- Corresponding author
- Du, Qiang
- Venue
- Current Medical Research and Opinion
- Publisher
- Informa UK Limited
- Published
- 2012-04-19
- Volume
- 28
- Issue
- 5
- Pages
- 723-730
- ISSN
- 0300-7995 (ISSN-L)
- 1473-4877
- OpenAlex
- W2100543832
- Cited by
- 53
- References
- 43
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 1 · 2018: 5 · 2017: 4 · 2016: 7 · 2015: 8 · 2014: 4 · 2013: 6 · 2012: 4
- FWCI
- 0.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Medical Research and Opinion (publishedVersion)
- PubMed (publishedVersion)
- Funders
- China Medical University
- Shengjing Hospital
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Kidney Cyst Diseases
- Keywords
- polycystic ovary syndrome, pioglitazone, metformin, insulin resistance, hyperinsulinemia, HOMA-IR, fasting insulin, body mass index, hirsutism, testosterone, Ferriman-Gallwey score, fasting blood glucose
- MeSH terms
- Pioglitazone, Blood Glucose, Female, Hirsutism, Humans, Hyperinsulinism, Insulin Resistance, Metformin, Polycystic Ovary Syndrome, Testosterone, Body Mass Index, Randomized Controlled Trials as Topic, Thiazolidinediones
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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