PDF(Pubmed)
Abstract：
BACKGROUND: The optimal drug for treatment with polycystic ovary syndrome (PCOS) was in debate. We did this network meta-analysis to assess the efficacy and safety of different drugs for reducing testosterone levels in women with PCOS.
METHODS: We searched studies from inception until January 10, 2023, through PubMed, Embase, and Cochrane Library database. All studies comparing different drugs for reducing testosterone levels in women with polycystic ovary syndrome were included in this network meta-analysis. Outcomes were total testosterone levels, free testosterone levels, and withdraw due to adverse events. We calculated the surface under the cumulative ranking curve (SUCRA) for each treatment.
RESULTS: Finally, a total of 13 studies were finally included in this network meta-analysis. In head-to-head comparison, atorvastatin (WMD -3.1, 95% CrI: -3.7 to -2.5), metformin (WMD -2.6, 95% CrI: -3.5 to -1.6), metformin + simvastatin (WMD -2.8, 95% CrI: -4.1 to -1.5), simvastatin (WMD -2.7, 95% CrI: -4.2 to -1.3), spironolactone (WMD -3.1, 95% CrI: -4.3 to -1.9), spironolactone + metformin (WMD -3.2, 95% CrI: -4.5 to -2.0) were all more effective than the placebo, and the difference was statistically significant (P < .05). The SUCRA shows that spironolactone + metformin ranked first (SUCRA, 85.0%), Atorvastatin ranked second (SUCRA, 77.7%), Spironolactone ranked third (SUCRA, 77.2%), and metformin + simvastatin ranked the fourth. The SUCRA of different drugs for free testosterone levels shows that atorvastatin ranked first (SUCRA, 75.0%), spironolactone + metformin ranked second (SUCRA, 5.3%), metformin + simvastain ranked third (SUCRA, 62.6%), and spironolactone ranked the fourth (SUCRA, 56.4%). No statistically significant differences were found between the 2 treatment groups for withdrawn due to adverse events (P > .05).
CONCLUSIONS: Considering the network meta-analysis and rankings, atorvastatin was recommended to be the optimal drug for treatment PCOS. However, the optimal dose of atorvastatin was unknown and should be verified by more randomized controlled trials.
METHODS: We searched studies from inception until January 10, 2023, through PubMed, Embase, and Cochrane Library database. All studies comparing different drugs for reducing testosterone levels in women with polycystic ovary syndrome were included in this network meta-analysis. Outcomes were total testosterone levels, free testosterone levels, and withdraw due to adverse events. We calculated the surface under the cumulative ranking curve (SUCRA) for each treatment.
RESULTS: Finally, a total of 13 studies were finally included in this network meta-analysis. In head-to-head comparison, atorvastatin (WMD -3.1, 95% CrI: -3.7 to -2.5), metformin (WMD -2.6, 95% CrI: -3.5 to -1.6), metformin + simvastatin (WMD -2.8, 95% CrI: -4.1 to -1.5), simvastatin (WMD -2.7, 95% CrI: -4.2 to -1.3), spironolactone (WMD -3.1, 95% CrI: -4.3 to -1.9), spironolactone + metformin (WMD -3.2, 95% CrI: -4.5 to -2.0) were all more effective than the placebo, and the difference was statistically significant (P < .05). The SUCRA shows that spironolactone + metformin ranked first (SUCRA, 85.0%), Atorvastatin ranked second (SUCRA, 77.7%), Spironolactone ranked third (SUCRA, 77.2%), and metformin + simvastatin ranked the fourth. The SUCRA of different drugs for free testosterone levels shows that atorvastatin ranked first (SUCRA, 75.0%), spironolactone + metformin ranked second (SUCRA, 5.3%), metformin + simvastain ranked third (SUCRA, 62.6%), and spironolactone ranked the fourth (SUCRA, 56.4%). No statistically significant differences were found between the 2 treatment groups for withdrawn due to adverse events (P > .05).
CONCLUSIONS: Considering the network meta-analysis and rankings, atorvastatin was recommended to be the optimal drug for treatment PCOS. However, the optimal dose of atorvastatin was unknown and should be verified by more randomized controlled trials.
摘要：
背景：治疗多囊卵巢综合征（PCOS）的最佳药物存在争议。我们进行了这项网络荟萃分析，以评估不同药物降低PCOS女性睾丸激素水平的有效性和安全性。
方法：我们通过PubMed搜索了从开始到2023年1月10日的研究，Embase,和Cochrane图书馆数据库。所有比较不同药物降低多囊卵巢综合征女性睾酮水平的研究均纳入该网络荟萃分析。结果是总睾酮水平，游离睾酮水平,并因不良事件退出。我们计算了每种处理的累积排序曲线(SUCRA)下的表面。
结果：最后，最终共有13项研究纳入本网络荟萃分析.在头对头比较中，阿托伐他汀（WMD-3.1，95%CrI：-3.7至-2.5），二甲双胍（WMD-2.6，95%CrI：-3.5至-1.6），二甲双胍+辛伐他汀（WMD-2.8，95％CrI：-4.1至-1.5），辛伐他汀（WMD-2.7，95%CrI：-4.2至-1.3），螺内酯（WMD-3.1，95%CrI：-4.3至-1.9），螺内酯+二甲双胍（WMD-3.2，95％CrI：-4.5至-2.0）都比安慰剂更有效，差异有统计学意义(P<0.05)。SUCRA显示螺内酯+二甲双胍排名第一(SUCRA，85.0%），阿托伐他汀排名第二（SUCRA，77.7%），螺内酯排名第三(SUCRA，77.2%），二甲双胍+辛伐他汀排名第四。不同药物对游离睾酮水平的SUCRA显示阿托伐他汀排名第一(SUCRA,75.0%），螺内酯+二甲双胍排名第二(SUCRA，5.3%），二甲双胍+辛伐他汀排名第三(SUCRA，62.6%），螺内酯排名第四(SUCRA，56.4%）。2个治疗组之间因不良事件退出的差异无统计学意义（P>0.05）。
结论：考虑到网络荟萃分析和排名，阿托伐他汀被推荐为治疗PCOS的最佳药物.然而,阿托伐他汀的最佳剂量未知,应通过更多随机对照试验加以验证.
方法：我们通过PubMed搜索了从开始到2023年1月10日的研究，Embase,和Cochrane图书馆数据库。所有比较不同药物降低多囊卵巢综合征女性睾酮水平的研究均纳入该网络荟萃分析。结果是总睾酮水平，游离睾酮水平,并因不良事件退出。我们计算了每种处理的累积排序曲线(SUCRA)下的表面。
结果：最后，最终共有13项研究纳入本网络荟萃分析.在头对头比较中，阿托伐他汀（WMD-3.1，95%CrI：-3.7至-2.5），二甲双胍（WMD-2.6，95%CrI：-3.5至-1.6），二甲双胍+辛伐他汀（WMD-2.8，95％CrI：-4.1至-1.5），辛伐他汀（WMD-2.7，95%CrI：-4.2至-1.3），螺内酯（WMD-3.1，95%CrI：-4.3至-1.9），螺内酯+二甲双胍（WMD-3.2，95％CrI：-4.5至-2.0）都比安慰剂更有效，差异有统计学意义(P<0.05)。SUCRA显示螺内酯+二甲双胍排名第一(SUCRA，85.0%），阿托伐他汀排名第二（SUCRA，77.7%），螺内酯排名第三(SUCRA，77.2%），二甲双胍+辛伐他汀排名第四。不同药物对游离睾酮水平的SUCRA显示阿托伐他汀排名第一(SUCRA,75.0%），螺内酯+二甲双胍排名第二(SUCRA，5.3%），二甲双胍+辛伐他汀排名第三(SUCRA，62.6%），螺内酯排名第四(SUCRA，56.4%）。2个治疗组之间因不良事件退出的差异无统计学意义（P>0.05）。
结论：考虑到网络荟萃分析和排名，阿托伐他汀被推荐为治疗PCOS的最佳药物.然而,阿托伐他汀的最佳剂量未知,应通过更多随机对照试验加以验证.
