Clinical Nursing & Practice

Biography

Dr. Juan Carlos Paredes Palma is a Specialist in internal medicine, Subspecialist in Endocrinology, Biology of human reproduction and endocrine gynecology, has a Master in Medical Sciences and a PHD in Health Sciences. He has held various positions in one of the most important public health institutions in Mexico; Institute of Social Security and Health of workers of the State, (ISSSTE), was National Coordinator of Clinical Research, Head of Teaching of the Hospital Dr. Darío Fernández Fierro of Mexico City and currently is the Head of Teaching and Research of the Delegation South of ISSSTE. He was the winner of The National Research prize of the ISSSTE in 2015

Abstract

Abstract

 

Objective

To determine the efficacy of sitagliptin alone or in combination with metformin in women with polycystic ovary in terms of ovarian cyclicity, fertility and cardiometabolic profile compared to metformin alone.

 

Rationale

Polycystic ovarian syndrome (PCOS) affects a percentage of 5–10% of women of reproductive age worldwide and has a prevalence of 6.6% (95% CI: 2.3–10.9%) in Mexican women and most common cause of infertility in developed countries.

Treatment with insulin sensitizing drugs (metformin and pioglitazone) has been shown to improve menstrual cyclicity and fertility in the metabolic profile with polycystic ovarian patients. Incretins and DPP-4 inhibitors have been shown to enhance pancreatic β cell activity, increasing weight loss by its anorexic effect and resulting in an adequate weight control and improved fertility.

Previous evidence has compared the effect of exenatide and alone or in combination with metformin in the treatment of PCOS, in this article we will compare sitagliptin and metformin alone or in combination.

 

Study design

Blind, controlled and randomized clinical trial.

Patients

Women between 18 and 40 years of age, with a BMI >20 and diagnosed with PCOS with the Rotterdam criteria.

 

Results

In the normalized index of menstruations it was found that there was a statistically significant intragroup increase in each one of the treatments. With a higher percentage of change, that of metformin with 80%, followed by that of sitagliptin with 65% and then COMBO with 30%. No statistically significant differences were found between treatment groups.

Conclusion

Therapeutic effect of sitagliptin was observed in patients with PCOS comparable to metformin and the combination of metformin-sitagliptin is more effective in terms of ovulation than the other two treatments alone.