Metformin versus pioglitazone in treatment of polycystic ovarian syndrome - A randomized control trial

Abstract

Objective: To compare the efficacy of metformin versus pioglitazone in the treatment of polycystic ovarian syndrome. Methods: A prospective randomized controlled trial with parallel assignment was conducted in the outpatient Gynecology clinic of Dow University Hospital and Mamji Hospital, Karachi, Pakistan. One hundred and twenty patients with polycystic ovarian syndrome were selected and randomized into two groups with 60 patients receiving metformin in dose of 500mg TDS and 60 receiving pioglitazone 30mg daily. Clinical and biochemical parameters were evaluated at recruitment and at six months after treatment. Data was entered and analyzed through SPSS version 21. Results: Patients in both groups were Age and BMI matched. Significant reductions in fasting insulin levels, total testosterone and free androgen levels were found in both groups after treatment (p<0.001). Clinical improvement in hirsutism and regularization of menstrual cycles was also observed in both groups (p<0.001). However statistically significant reduction in BMI was observed in metformin group (p<0.001) than in the pioglitazone group (p=0.878). Conclusion: We conclude that both metformin and pioglitazone are effective in treatment of polycystic ovarian syndrome in terms of reduction of clinical and biochemical hyperandrogenism, regularization of menstrual cycles and restoration of ovulation. However metformin was found to be more effective in weight reduction