Comparison of effects of 3 mg drospirenone plus 20 μg ethinyl estradiol alone or combined with metformin or cyproterone acetate on classic metabolic cardiovascular risk factors in nonobese women with polycystic ovary syndrome.
OBJECTIVE
To evaluate the effects of a pill with drospirenone (3 mg) plus ethinyl E(2) (20 μg) (DRP/20EE) alone or associated with metformin or cyproterone acetate (CPA) on some metabolic cardiovascular risk factors in women with polycystic ovary syndrome (PCOS).


METHODS
Randomized, open-label clinical trial.


METHODS
Academic medical clinic.


METHODS
Forty-eight hirsute women with PCOS.


METHODS
Patients were randomized to treatment with DRP/20EE or with DRP/20EE plus metformin (1,500 mg/d) or with DRP/20EE plus CPA (12.5 mg/d, 10 days per cycle) for 6 months.


METHODS
Blood pressure, lipid profile, and indexes of glucose tolerance and insulin sensitivity were assessed before and after 6 months of treatment.


RESULTS
Body mass index and blood pressure were not modified by any treatment. Treatment with DRP/EE20 did not change the lipid profile; DRP/EE20 plus metformin significantly increased high-density lipoprotein cholesterol concentrations; DRP/EE20 plus CPA significantly increased triglycerides and total cholesterol. The area under the curve for insulin was significantly decreased by DRP/EE20 and DRP/EE20 plus metformin, but it was significantly increased by DRP/EE20 plus CPA. Treatment with DRP/EE20 plus CPA significantly increased the homeostasis model assessment of insulin resistance index and significantly reduced the glucose to insulin ratio index. Treatment with DRP/EE20 significantly increased the glucose to insulin ratio index.


CONCLUSIONS
Treatment with DRP/EE20 improved insulin sensitivity in hirsute women with PCOS, with no deterioration of lipid profile. This effect was not ameliorated by the addition of metformin. The positive metabolic effects of DRP are abolished by the concomitant use of CPA.
Fruzzetti
Franca
F
Department of Obstetrics and Gynecology, Ospedale S. Chiara, University of Pisa, Pisa, Italy. ffruzzi@tin.it
Perini
Daria
D
Lazzarini
Veronica
V
Parrini
Donatella
D
Gambacciani
Marco
M
Genazzani
Andrea Riccardo
AR
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood; D000736:Androstenes / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D003534:Cyproterone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004967:Estrogens / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008687:Metformin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000451:Mineralocorticoid Receptor Antagonists / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D012307:Risk Factors; D055815:Young Adult
D000728:Androgens; D000736:Androstenes; D004967:Estrogens; D007004:Hypoglycemic Agents; D007328:Insulin; D008055:Lipids; D000451:Mineralocorticoid Receptor Antagonists; D004997:Ethinyl Estradiol; D008687:Metformin; D003534:Cyproterone; D005947:Glucose; C035144:drospirenone