Metformin and Lifestyle Intervention in Women With Polycystic Ovary Syndrome

Overview[ - collapse ][ - ]

Purpose Polycystic ovary syndrome is a frequent cause of abnormal menses and infertility. It has also been related to cardiovascular disease. The objective of this trial is to evaluate the clinical and metabolic efficacy of metformin plus life style modifications in women with polycystic ovary syndrome compared with life style modifications and placebo
ConditionPolycystic Ovary Syndrome
InterventionDrug: Metformin
Drug: Placebo
PhasePhase 4
SponsorHospital Privado de Cordoba, Argentina
Responsible PartyHospital Privado de Cordoba, Argentina
ClinicalTrials.gov IdentifierNCT00679679
First ReceivedMay 15, 2008
Last UpdatedMay 16, 2008
Last verifiedMay 2008

Tracking Information[ + expand ][ + ]

First Received DateMay 15, 2008
Last Updated DateMay 16, 2008
Start DateJanuary 2003
Estimated Primary Completion DateDecember 2005
Current Primary Outcome MeasuresBody mass index,Normalization of menses,Pregnancy,Hirsutism,Waist to hip ratio, Testosterone, Androstenedione, DHEAS,Progesterone, FSH, LH,Glucose, OGTT,Insulinemia,Total HDL and LDL Cholesterol, Triglycerides,Uric acid, Prostate specific antigen [Time Frame: 4 months] [Designated as safety issue: No]
Current Secondary Outcome MeasuresNot Provided

Descriptive Information[ + expand ][ + ]

Brief TitleMetformin and Lifestyle Intervention in Women With Polycystic Ovary Syndrome
Official TitleClinical Metabolic and Endocrine Parameters in Response to Metformin and Lifestyle Intervention in Women With Polycystic Ovary Syndrome: A Phase 4 Randomized, Double- Blind and Placebo Control Trial
Brief Summary
Polycystic ovary syndrome is a frequent cause of abnormal menses and infertility. It has
also been related to cardiovascular disease.

The objective of this trial is to evaluate the clinical and metabolic efficacy of metformin
plus life style modifications in women with polycystic ovary syndrome compared with life
style modifications and placebo
Detailed Description
Polycystic ovary syndrome (PCOS) is a common and heterogeneous disorder of women in
reproductive age. It is characterized by hyperandrogenism and chronic anovulation. Several
studies in diverse populations estimate it's prevalence at 5-10%. Women present, in a high
percentage of cases, with obesity, hirsutism, acne, menstrual irregularities and
infertility. Although the exact physiopathology of PCOS remains unknown, several studies
tend to point to insulinoresistance (IR) as the cause of the syndrome. IR is present in 60
to 70% of patients independently of obesity. Compensatory hyperinsulinism has a pivotal role
in the physiopathogenesis of PCOS. In vitro, insulin stimulates androgen synthesis in thecal
cells and decrease sex hormone-binding globulin synthesis in the liver, increasing free
androgen availability.

Due to the high prevalence of IR, PCOS shares components of metabolic syndrome: abdominal
obesity, impaired glucose tolerance, gestational and type 2 diabetes, abnormalities in lipid
profile, blood hypertension, endothelial dysfunction and probably cardiovascular disease.

In the past, PCOS treatment was focus on ovulation induction for infertility, oral
contraceptives for irregular bleeding, and androgens antagonists for hirsutism or acne. In
later years insulin sensitizing agents have been used to reduce hyperinsulinemia, improve
ovary function and associated metabolic abnormalities. Metformin (MTF), a biguanide,
usually used in obese patients with type 2 diabetes,inhibits glucose hepatic
production,decreases insulin secretion and increases peripheral insulin sensitivity.

Some studies have reported an improvement in insulin sensitivity associated with reduction
of hyperandrogenism and improvements in reproductive abnormalities with MTF. On the other
hand, other authors failed to observe those changes. However, an off label indication for it
usage in PCOS for FDA and the lack of large controlled trials, MTF indication to treat PCOS
has grown dramatically in later years.

In obese women with PCOS, weight loss effectively ameliorates hyperandrogenism and metabolic
disorders by improving insulin resistance.

Some trials have suggested that those effects could be improved with insulin sensitizing
agents without changes in body weigh.

The present study was designed to assess, in a randomized, double-blind, placebo-controlled
way, the effects of MTF in addition to lifestyle modifications on endocrine and metabolic
disturbances in women with PCOS.
Study TypeInterventional
Study PhasePhase 4
Study DesignAllocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
ConditionPolycystic Ovary Syndrome
InterventionDrug: Metformin
Metformin 750 mg BID for 4 months
Other Names:
D.B.I. 500 mg. 1 1/2 tables BIDDrug: Placebo
Diet counseling and exercise
Study Arm (s)
  • Experimental: Metformin
    Every patient will be given diet and exercise counseling in both arms. Intervention arm will receive metformin
  • Placebo Comparator: Placebo
    Every patient will be given diet and exercise counseling in both arms. Intervention arm will receive metformin

Recruitment Information[ + expand ][ + ]

Recruitment StatusCompleted
Estimated Enrollment30
Estimated Completion DateDecember 2005
Estimated Primary Completion DateSeptember 2005
Eligibility Criteria
Inclusion Criteria:

- Women in reproductive age

- With polycystic ovary syndrome defined by hyperandrogenism (elevated serum
testosterone concentrations), and oligomenorrhea (cycles of 35 days or longer), or
amenorrhea (no menses in the last 6 months) after negative screening pregnancy test

Exclusion Criteria:

- Pregnancy

- Cushing' s syndrome

- Late onset congenital adrenal hyperplasia

- Androgen-secreting tumors

- Uncontrolled thyroid disease

- Hyperprolactinemia

- Diabetes any

- Cardiovascular diseases (Ischaemic heart disease, uncontrolled hypertension, heart
failure)

- Acute or chronic infections at baseline

- Renal disease

- Liver disease

- Had taken any medications for at least 3 months before enrolment in the study.
GenderFemale
Ages18 Years
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesArgentina

Administrative Information[ + expand ][ + ]

NCT Number NCT00679679
Other Study ID NumbersFux-1
Has Data Monitoring CommitteeNo
Information Provided ByHospital Privado de Cordoba, Argentina
Study SponsorHospital Privado de Cordoba, Argentina
CollaboratorsNot Provided
Investigators Principal Investigator: Carolina Fux Otta, MD
Verification DateMay 2008

Locations[ + expand ][ + ]

Hospital Privado de Córdoba
Cordoba, Argentina, X5016KEH