Rosiglitazone and ethinyl estradiol/cyproterone acetate as single and combined treatment of overweight women with polycystic ovary syndrome and insulin resistance.
BACKGROUND
Few studies have evaluated insulin sensitizers in comparison/association with oral contraceptives (OC) in women with polycystic ovary syndrome (PCOS) with insulin resistance (IR). This study assessed the effects of a thiazolidinedione versus an anti-androgenic estrogen-progestin followed by their sequential combinations in overweight PCOS women.


RESULTS
Twenty-eight candidates in whom elevated insulin was not normalized after 4 months of diet were randomly assigned to 6 months of rosiglitazone 4 mg/day or to ethinyl estradiol 35 mg/cyproterone acetate 2 mg (EE/CPA: 21/28 days cycle). Each group then received both medications for another 6 months. Rosiglitazone reduced insulin, IR indices [homeostasis model assessment (HOMA) and quantitative sensitivity check index (QUICKI)] and the insulin area under the curve in response to an oral glucose tolerance test (OGTT), but had limited effect on lipids, androgens and hirsutism. EE/CPA did not modify insulin and OGTT response but increased high-density lipoprotein cholesterol and triglycerides and decreased androgens and hirsutism. Similar changes occurred during combined treatments. End results were highly significant in combined groups without noticeable side-effects or changes in safety parameters.


CONCLUSIONS
In obese PCOS women with high insulin not corrected by diet, the combination of rosiglitazone and EE/CPA may be used to achieve complementary beneficial effects on endocrine-metabolic anomalies and clinical symptoms.
Lemay
A
A
Département d'Obstétrique-Gynécologie, Centre de Recherche, Hôpital St-François d'Assise, CHUQ, Université Laval, Québec, Canada. andre.lemay@ogy.ulaval.ca
Dodin
S
S
Turcot
L
L
Déchêne
F
F
Forest
J-C
JC
D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood; D001786:Blood Glucose; D008076:Cholesterol, HDL / Q000097:blood; D017373:Cyproterone Acetate / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004997:Ethinyl Estradiol / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006628:Hirsutism / Q000139:chemically induced; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000188:drug therapy*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy*; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000008:administration & dosage* / Q000627:therapeutic use
D000728:Androgens; D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate