Metformin vs thiazolidinediones for treatment of clinical, hormonal and metabolic characteristics of polycystic ovary syndrome: a meta-analysis

Summary Objectives Insulin‐sensitizing drugs (ISDs) have been advocated for the long‐term treatment of polycystic ovary syndrome (PCOS). It is therefore important to compare the efficacy and safety of ISDs such as metformin and thiazolidinediones (TZDs) for the treatment of this syndrome. Methods A meta‐analysis to assess the effectiveness and safety of metformin vs TZDs (including pioglitazone and rosiglitazone) in the treatment of PCOS was conducted, using MEDLINE (1966–May 2010) and EMBASE (1988–May 2010) to select randomized controlled trials comparing clinical, hormonal and metabolic results. Results Ten trials were included. TZDs were superior to metformin in reducing serum levels of free testosterone (P = 0·03) and dehydroepiandrosterone sulfate (DHEA) (P = 0·002) after 3 months treatment. Decreases in triglyceride levels were more pronounced with metformin after 6 months (P