A comparison between rimonabant and metformin in reducing biochemical hyperandrogenaemia and insulin resistance in patients with polycystic ovary syndrome (PCOS)

A randomized open-label parallel study

Thozhukat Sathyapalan, Li Wei Cho, Eric S. Kilpatrick, Anne Marie Coady, Stephen Atkin

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Context: Weight loss and metformin therapy are reported to be beneficial in improving the biochemical hyperandrogenaemia and insulin resistance of polycystic ovary syndrome (PCOS). Rimonabant has been found to reduce weight and improve the metabolic profile in patients with obesity, type 2 diabetes and metabolic syndrome. Objective: To compare the effects of insulin sensitization with metformin to weight reduction by rimonabant on biochemical hyperandrogenaemia and insulin resistance in patients with PCOS. Design: A randomized, open-label parallel study. Setting: Endocrinology outpatient clinic in a referral centre. Subjects: Twenty patients with PCOS and biochemical hyperandrogenaemia with a body mass index (BMI) ≥ 30 kg/m2 were recruited. Intervention: Patients were randomized to 1.5 g daily of metformin or 20 mg daily of rimonabant. Main outcome measures: The primary end-point of the study was a change in total testosterone. Results: After 12 weeks of rimonabant there was a significant reduction (mean ± SEM) in weight (104.6 ± 4.6 vs. 98.4 ± 4.7 kg, P < 0.01), waist circumference (116.0 ± 3.3 vs. 109.2 ± 3.7 cm, P < 0.01), hip circumference (128.5 ± 4.0 vs. 124.1 ± 4.2 cm, P < 0.03), waist-hip ratio (0.90 ± 0.02 vs. 0.88 ± 0.01, P < 0.01) free androgen index (FAI) (26.6 ± 6.1 vs. 16.6 ± 4.1, P < 0.01), testosterone [4.6 ± 0.4 vs. 3.1 ± 0.3 nmol/l (132.7 ± 11.5 vs. 89.4 ± 8.65 ng/dl), P < 0.01] and insulin resistance as measured by the homeostasis model assessment (HOMA) method (4.4 ± 0.5 vs. 3.4 ± 0.4, P = 0.05). There was no change in any of these parameters in the metformin-treated group. Conclusion: This study suggests that the weight loss through rimonabant therapy may be of use in patients with PCOS and appears superior to insulin sensitization by metformin in reducing the FAI and insulin resistance in obese PCOS patients treated over a 12-week period.

Original languageEnglish
Pages (from-to)931-935
Number of pages5
JournalClinical Endocrinology
Volume69
Issue number6
DOIs
Publication statusPublished - Dec 2008
Externally publishedYes

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rimonabant
Polycystic Ovary Syndrome
Metformin
Insulin Resistance
Weight Loss
Androgens
Testosterone
Insulin
Weights and Measures
Waist-Hip Ratio
Metabolome
Endocrinology
Waist Circumference
Ambulatory Care Facilities
Type 2 Diabetes Mellitus
Hip
Body Mass Index
Homeostasis
Referral and Consultation
Obesity

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

A comparison between rimonabant and metformin in reducing biochemical hyperandrogenaemia and insulin resistance in patients with polycystic ovary syndrome (PCOS) : A randomized open-label parallel study. / Sathyapalan, Thozhukat; Cho, Li Wei; Kilpatrick, Eric S.; Coady, Anne Marie; Atkin, Stephen.

In: Clinical Endocrinology, Vol. 69, No. 6, 12.2008, p. 931-935.

Research output: Contribution to journalArticle

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abstract = "Context: Weight loss and metformin therapy are reported to be beneficial in improving the biochemical hyperandrogenaemia and insulin resistance of polycystic ovary syndrome (PCOS). Rimonabant has been found to reduce weight and improve the metabolic profile in patients with obesity, type 2 diabetes and metabolic syndrome. Objective: To compare the effects of insulin sensitization with metformin to weight reduction by rimonabant on biochemical hyperandrogenaemia and insulin resistance in patients with PCOS. Design: A randomized, open-label parallel study. Setting: Endocrinology outpatient clinic in a referral centre. Subjects: Twenty patients with PCOS and biochemical hyperandrogenaemia with a body mass index (BMI) ≥ 30 kg/m2 were recruited. Intervention: Patients were randomized to 1.5 g daily of metformin or 20 mg daily of rimonabant. Main outcome measures: The primary end-point of the study was a change in total testosterone. Results: After 12 weeks of rimonabant there was a significant reduction (mean ± SEM) in weight (104.6 ± 4.6 vs. 98.4 ± 4.7 kg, P < 0.01), waist circumference (116.0 ± 3.3 vs. 109.2 ± 3.7 cm, P < 0.01), hip circumference (128.5 ± 4.0 vs. 124.1 ± 4.2 cm, P < 0.03), waist-hip ratio (0.90 ± 0.02 vs. 0.88 ± 0.01, P < 0.01) free androgen index (FAI) (26.6 ± 6.1 vs. 16.6 ± 4.1, P < 0.01), testosterone [4.6 ± 0.4 vs. 3.1 ± 0.3 nmol/l (132.7 ± 11.5 vs. 89.4 ± 8.65 ng/dl), P < 0.01] and insulin resistance as measured by the homeostasis model assessment (HOMA) method (4.4 ± 0.5 vs. 3.4 ± 0.4, P = 0.05). There was no change in any of these parameters in the metformin-treated group. Conclusion: This study suggests that the weight loss through rimonabant therapy may be of use in patients with PCOS and appears superior to insulin sensitization by metformin in reducing the FAI and insulin resistance in obese PCOS patients treated over a 12-week period.",
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T2 - A randomized open-label parallel study

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AU - Cho, Li Wei

AU - Kilpatrick, Eric S.

AU - Coady, Anne Marie

AU - Atkin, Stephen

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N2 - Context: Weight loss and metformin therapy are reported to be beneficial in improving the biochemical hyperandrogenaemia and insulin resistance of polycystic ovary syndrome (PCOS). Rimonabant has been found to reduce weight and improve the metabolic profile in patients with obesity, type 2 diabetes and metabolic syndrome. Objective: To compare the effects of insulin sensitization with metformin to weight reduction by rimonabant on biochemical hyperandrogenaemia and insulin resistance in patients with PCOS. Design: A randomized, open-label parallel study. Setting: Endocrinology outpatient clinic in a referral centre. Subjects: Twenty patients with PCOS and biochemical hyperandrogenaemia with a body mass index (BMI) ≥ 30 kg/m2 were recruited. Intervention: Patients were randomized to 1.5 g daily of metformin or 20 mg daily of rimonabant. Main outcome measures: The primary end-point of the study was a change in total testosterone. Results: After 12 weeks of rimonabant there was a significant reduction (mean ± SEM) in weight (104.6 ± 4.6 vs. 98.4 ± 4.7 kg, P < 0.01), waist circumference (116.0 ± 3.3 vs. 109.2 ± 3.7 cm, P < 0.01), hip circumference (128.5 ± 4.0 vs. 124.1 ± 4.2 cm, P < 0.03), waist-hip ratio (0.90 ± 0.02 vs. 0.88 ± 0.01, P < 0.01) free androgen index (FAI) (26.6 ± 6.1 vs. 16.6 ± 4.1, P < 0.01), testosterone [4.6 ± 0.4 vs. 3.1 ± 0.3 nmol/l (132.7 ± 11.5 vs. 89.4 ± 8.65 ng/dl), P < 0.01] and insulin resistance as measured by the homeostasis model assessment (HOMA) method (4.4 ± 0.5 vs. 3.4 ± 0.4, P = 0.05). There was no change in any of these parameters in the metformin-treated group. Conclusion: This study suggests that the weight loss through rimonabant therapy may be of use in patients with PCOS and appears superior to insulin sensitization by metformin in reducing the FAI and insulin resistance in obese PCOS patients treated over a 12-week period.

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