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Published Online, 6 May 2008, www.theannals.com, DOI 10.1345/aph.1K639.
 The Annals of Pharmacotherapy: Vol. 42, No. 6, pp. 847-851. DOI 10.1345/aph.1K639
© 2008 Harvey Whitney Books Company.
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DRUG INFORMATION ROUNDS

Acarbose for Polycystic Ovary Syndrome

Christine Kircher

PharmD Student, College of Pharmacy, University of Southern Nevada, Henderson, NV

Katherine P Smith, PharmD BCPS

Director of Continuing Education; Associate Professor of Pharmacy Practice, College of Pharmacy, University of Southern Nevada

Reprints: Dr. Smith, College of Pharmacy, University of Southern Nevada, 11 Sunset Way, Henderson, NV 89014, fax 702/990-4435, ksmith{at}usn.edu

OBJECTIVE: To review the evidence for use of acarbose in the management of polycystic ovary syndrome (PCOS).

DATA SOURCES: Relevant publications were identified through a systematic search of PubMed English-language literature (1950–February 2008) using the MeSH terms and key words acarbose and polycystic ovary syndrome.

STUDY SELECTION AND DATA EXTRACTION: The literature search retrieved 6 primary literature citations. Three randomized controlled clinical trials and one open-label study were evaluated. The other 2 citations were not evaluated due to only a peripheral mention of PCOS in relation to diabetes.

DATA SYNTHESIS: PCOS is a complex disorder presenting most commonly with oligomenorrhea or amenorrhea, infertility, hirsutism, acne, and obesity. Acarbose is a promising therapy for PCOS because of its effects on postprandial insulin levels. In multiple clinical studies, acarbose improved hirsutism, acne, and menstrual irregularities through reduction in androgen concentrations and through increased androgen binding. When compared with metformin in women with PCOS and clomiphene-resistant infertility, acarbose induced greater weight loss and improved menstrual regularity and signs of fertility to a similar degree. Markers of cardiovascular risk were also significantly improved following 6 months of acarbose therapy in obese women with PCOS. Adverse effects, specifically gastrointestinal, were documented. Despite promising results, the studies were limited by small sample sizes and, in some cases, methods that were not clearly defined.

CONCLUSIONS: Several trials have evaluated the use of acarbose in the management of PCOS with positive clinical evidence, but the results of these trials have not been corroborated by more rigorous studies.

Key Words: acarbose, polycystic ovary syndrome

Published Online, May 6, 2008. www.theannals.com, DOI 10.1345/aph.1K639




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