A Systematic Review and Meta-Analysis of Acarbose in the Treatment of Polycystic Ovary Syndrome

Objective: To evaluate the efficacy and tolerability of acarbose in the treatment of Polycystic Ovary Syndrome (PCOS). Methods: We researched the database of PubMed, Biomedical Core Database (BCD), Cochrane library databases, and Chinese Biological Medicine for Randomly Control Trials (RCTs) and analyzed the retrospect data of acarbose in the treatment of PCOS. Results: There are seven RCTs that met the inclusion criteria. As different control groups (placebo or metformin) have been used in these trials, we separated the data into two independent groups. The dose of acarbose in the treatment groups ranged from 150 to 300 mg/day. VLDL, triglycerides, Luteinizing Hormone (LH), testosterone, and Dehydroepiandrosterone Sulfate (DHEAS) levels decreased, whereas HDL significantly increased in acarbose groups when compared with the placebo groups. Acarbose treatment also improved menstrual frequency and insulin level. We couldn't find any differences between acarbose group and metformin group in fasting insulin level, BMI, LH, FSH, and testosterone level. However, based on these three RCTs data, the pregnancy rate was higher in acarbose group than that in metformin group (OR=3.02, 95% CI: 1.10-7.71, P=0.02). The gastrointestinal adverse effects of acarbose were found to be higher in treatment groups than those in placebo groups, and similar to or slightly less than those in metformin groups. Conclusions: Treatment with acarbose, at the dose of 150-300 mg/d, has been shown to improve various clinical manifestations of PCOS and be a safe and effective drug for the treatment of these patients, especially for patients who are intolerant of metformin. However, it may be too early to draw conclusions due to limitations in the currently available data.