Adverse Effects of the Common Treatments for Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis
| Autor: | Patricia J. Erwin, Victor M. Montori, Gabriela Prutsky, Rebecca J. Mullan, Corrine K. Welt, Vishnu Sundaresh, Amy T. Wang, David A. Ehrmann, Mohammad Hassan Murad, Juan Pablo Domecq |
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| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism education Clinical Biochemistry MEDLINE Context (language use) CINAHL Cochrane Library Biochemistry Endocrinology Risk Factors Internal medicine medicine Humans Hypoglycemic Agents Adverse effect Evidence-Based Medicine business.industry Biochemistry (medical) Androgen Antagonists Venous Thromboembolism Special Features Polycystic ovary Flutamide Metformin Meta-analysis Female Observational study business Contraceptives Oral Polycystic Ovary Syndrome |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 98:4646-4654 |
| ISSN: | 1945-7197 0021-972X |
| DOI: | 10.1210/jc.2013-2374 |
| Popis: | Polycystic ovary syndrome (PCOS) is common among women of childbearing age and the available pharmacological therapies have different side-effect profiles.We summarized the evidence about the side effects of oral contraceptive pills, metformin, and anti-androgens in women with PCOS.Sources included Ovid Medline, OVID EMBASE, OVID Cochrane Library, Web of Science, Scopus, PsycInfo, and CINAHL from inception through April 2011.We included comparative observational studies enrolling women with PCOS who received the agents of choice for at least 6 months and reported adverse effects.Using a standardized, piloted, and Web-based data extraction form and working in duplicate, we abstracted data from each study and performed meta-analysis when possible.We found 22 eligible studies of which 20 were randomized. No study reported severe side effects (eg, lactic acidosis, thromboembolic episodes, liver toxicity, cancer incidence, or pregnancy loss). Meta-analysis demonstrated no significant change in weight in oral contraceptive pills or flutamide users. Indirect evidence from populations without PCOS demonstrated no increased risk of lactic acidosis with metformin, only case reports of liver toxicity with flutamide (no comparative evidence), and increased relative risk difference of venous thromboembolism with oral contraceptive pills but very low absolute risk. Evidence on mortality, cardiovascular mortality, and cancer was inconclusive.Drugs commonly used to treat PCOS appear to be associated with very low risk of severe adverse effects although data are extrapolated from other populations. |
| Databáze: | OpenAIRE |
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