Reproductive System & Sexual Disorders: Current Research
Open Access
ISSN: 2161-038X
+44 1300 500008
ISSN: 2161-038X
+44 1300 500008
Haidy M. Sami, Noha Alaa Hamdy, Hanan Nabil, Ahmed I. ElMallah
Delta University Drug Information Center, Egypt Alexandria University, Egypt
Scientific Tracks Abstracts: Reprod Syst Sex Disord
Problem/Background: Polycystic ovarian syndrome (PCOS) is one of the most prevalent neuroendocrine disorders of the reproductive system. PCOS exhibits heterogeneity of symptoms as a result of the involvement of multiple pathways and the lack of utilized clues. Metformin increases insulin sensitivity, but it is associated with unsatisfied benefits on fertility in PCOS. Recent studies have reported that Dipeptidyl-Peptidase-4 Inhibitors (DPP-4is), Sodium/glucose cotransporter-2 inhibitors (SGLT-2is) improve ovarian cycles in PCOS. The purpose of this study is to compare the efficacy of Empagliflozin (SGLT-2i) or Linagliptin (DPP-4i) versus Metformin for treatment of infertile PCOS women. Methodology: In this randomized, controlled trial, 135 PCOS women (20-36 years-old) were classified into three-groups: group-1, involved 45 PCOS patients received Metformin (1500 mg orally/day); group-2, consisted of 45 PCOS patients received Empagliflozin (25 mg orally/day); and group-3, included 45 PCOS patients received Linagliptin (10 mg orally/day). Patients were recruited from the Gynecologic and Obstetric outpatient’s clinics, Mansoura-University-Hospitals, Egypt and assessed before, 3-months after intervention and 6-months of follow-up for determination of menstrual-cycle, dermatologic-signs, ultrasound-characteristics, pregnancyrate, FSH, LH, AMH, progesterone, total-testosterone, SHBG, FAI, DHEAS, HbA1C% and HOMA-IR. Data were statistically analyzed by one-way-analysis of variance (ANOVA), (p < 0.05). Findings: The current study reported that the potential roles of Linagliptin or Empagliflozin versus Metformin in improvement of ovulation and fertility in PCOS. As compared to group-1 and 2, group-3 (Linagliptin) showed significant difference in most measured parameters after 3-months of therapy and 6-months of follow-up (p<0.05), including significant improvement in menstrual regularity (33.3%, 35.6%, 95.6%), respectively and pregnancy rate (31.1%, 22.2%, 84.4%), respectively. Conclusion: This research came to clarify the emerging roles of these pharmacotherapies in treatment of infertile PCOS patients. The current study indicates that Linagliptin is a promising approach in treatment of PCOS and prevention of its related complication, also other DPP-4is could be examined
Haidy M. Sami, Clinical pharmacy instructor and Director of DIC at Delta University. I have expertise in clinical practice in different facilities, specialties and a passion for improving the clinical application of medications. I have built this model after years of experience in research, teaching, and residence in hospitals and educational institutions. This approach includes reviewing the research idea in terms of how to apply it and benefit patients from it. In this work, I participated in determining the criteria for inclusion, exclusion of patients and reviewing the methods of randomization of patients into groups and the drugs used. I participated in determining the required laboratory analysis. Finally, I calculated and personalized the dosage regimen of these pharmacotherapies based on patient preferences, the risk of adverse effects of therapy, and patient comorbid conditions in relation to the cost-effectiveness analysis.