| Diabetes drug shows promise for
ovary syndrome
By Anthony J. Brown, MD
NEW YORK (Reuters Health) - Women with a condition called polycystic
ovary syndrome (PCOS) suffer from hormonal irregularities that can
cause ovulation problems, excess hair, acne and reduced response
to insulin that makes them prone to diabetes. Now, researchers have
found that a drug used to treat diabetes seems to help.
Treatment with Avandia improved ovulation and insulin sensitivity
in women with PCOS and insulin resistance, according to findings
presented at the annual meeting of The Endocrine Society in New
Orleans.
However, researchers say, further studies are needed to clarify
whether Avandia is useful for PCOS patients without insulin resistance.
About 5 to 10 percent of women have PCOS. The underlying problem
is an excess of male hormones, or androgens. Insulin resistance
leads to elevated levels of insulin, which stimulates androgen release,
making the problem worse. Therefore, insulin-sensitizing agents
like Avandia could, in theory, improve the symptoms of PCOS, by
promoting a drop in insulin levels.
"Over 20 years ago, the association between PCOS and insulin
resistance was unearthed," Dr. Nicholas Cataldo, from Stanford
University in California, told Reuters Health. "About 10 years
ago, people started using metformin to treat women with PCOS."
Metformin, an older type of insulin sensitizer, proved to be an
effective treatment for PCOS, but "many women experience gastrointestinal
side effects, such as diarrhea, nausea, and loss of appetite,"
Cataldo said. "So, it has not been an ideal agent."
This led Cataldo's group to try the newest insulin sensitizer,
Avandia (known technically as rosiglitazone), which was approved
for treating type 2 diabetes in 1999.
In a study, 42 women with PCOS and insulin resistance were randomly
assigned to take one of three doses of Avandia for 12 weeks.
"As expected, treatment with rosiglitazone improved their
insulin resistance and reduced their insulin levels, an effect that
was most pronounced with the highest dose," Cataldo said.
"On the reproductive side, we were happy to see that 55 percent
of the women ovulated at least once during the 12-week period. Untreated,
these women would probably ovulate just once or twice a year,"
the researcher explained.
In addition, Avandia was well tolerated and did not produce the
troubling gastrointestinal side effects often seen with metformin,
he added.
Because rosiglitazone is limited in its ability to reduce androgen
levels, Cataldo said he does not think the drug is suitable to be
taken on a continuous basis for treating other PCOS-related problems
like excess hair. Rather, "I see the drug being used on a short-term
basis as a means to promote ovulation," he said.
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