Meta AnalysisID 3601
二甲双胍、肌醇、生活方式改变和草药在改善多囊卵巢综合征患者内分泌和临床指标方面的有效性和安全性比较研究：系统评价和网状Meta分析
CRD42022380602
To find out the comparative safety and effectiveness of treatment for the patients of PCOS by performing network meta-analysis in between existing treatment options.
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Record Fields
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- Meta Analysis Id
- 3601
- Evidence Id
- 12159
- Core Evidence Id
- 12159
- Source Meta Analysis Id
- 3558
- Herb2 Meta Analysis Id
- HBMA003558
- Crd Id
- CRD42022380602
- Title
- Study of comparative effectiveness and safety of metformin, myoinositol, life style changes and herbal medicines in improving endocrine and clinical variables in management PCOS patients a systematic review and a network meta-analysis.
- Review Question
- To find out the comparative safety and effectiveness of treatment for the patients of PCOS by performing network meta-analysis in between existing treatment options.
- Study Type Included
- Only Randomized controlled trials (RCTs) having metformin/myoinositol/herbal medicines/lifestyle changes and duration between 12-24 weeks will be included in the analysis. Non randomized clinical trials, observational studies, studies published in languages other than English, studies whose full text are not available will be not be considered for analysis.
- Condition Being Studied
- Polycystic ovarian syndrome (PCOS) is the most common reason of infertility affecting about 5 -20% of the reproductive female population. It is a complex syndrome related to insulin resistance, compensatory hyperinsulinemia and obesity. The important feature is hyperandrogenism – clinically features of excess of androgens/testosterone or biochemically excess of testosterone in blood – hyperandrogenemia, oligo-ovulation or anovulation and polycystic appearance of ovaries on ultrasonography. Rotterdam criteria is used to diagnose the cases includes hyperandrogenism, oligo-ovulation and polycystic ovaries. The treatment may be aimed at the specific requirement of the patient. Therapeutic options - PCOS presents with disturbances in pulse frequency of GnRh, excess of LH and reduced or normal FSH. Excessive production of testosterone by ovaries is the major complicating factor. Obstetric complications, metabolic syndrome, type 2 diabetes and cardiovascular diseases are associated with PCOS. Insulin resistance remains the mainstay of the pathophysiology. Insulin sensitizers are recommended in the treatment of PCOS. Metformin, myo-inositol, pioglitazone, alogliptin, exenatide, simvastatin, orlistat, OCPs, vit D, herbal medicines, lifestyle management and many more options are available to treat PCOS. Clomiphene citrate, letrozole, gonadotrophins & laparoscopic ovarian drilling are used for induction of ovulation in the patient desirous of pregnancy.
- Participant
- Data only from RCTs will be considered - 1. Study should have adolescent and adult female patients of PCOS. 2. Patients’ recruitment may be from clinic or from hospital.
- Animal
- Human Disease Modelled
- Intervention
- All RCT having interventions 1. Metformin. 2. Myoinositol. 3. Any herbal medicine. 4. Lifestyle changes/modifications will be considered for analysis.
- Comparator Control
- Standard of care or placebo
- Main Outcome
- Comparison between the available treatment options for PCOS is expected to generate robust data whether any treatment is better or not including the herbal and lifestyle modifications. Measures of effect The point estimate (Mean Difference - MD) and standard deviations (SD) before & after treatment in different arms of the study will extracted or if not available will be calculated with existing data, if possible, for different variables for individual study. If SD associated with mean difference is not reported then 95% confidence interval (CI) will be used for calculation of SD. A network meta-analysis will be performed to compare the efficacy of different treatment options for varies variables like fasting insulin levels, F-BSL, IR, testosterone, FSH, LH, menstrual regulation BMI, WHR etc. Network meta-analysis will be performed to combine the results from direct and indirect comparisons of treatment effect in single analysis.
- Outcome Measure
- Additional Outcome
- This shall inform the gynaecologist for choosing the optimal treatment option for patient with PCOS. Measures of effect Mean, Mean difference and Standard Deviation.
- Study Method
- Network meta-analysis, Systematic review
- Keyword
- Female; Humans; Inositol; Life Style; Metformin; Plants, Medicinal; Polycystic Ovary Syndrome
- Contact
- Shantanu Joshi [email protected]
- Organisational Affiliation
- Seth G. S. Medical College and KEM Hospital, Mumbai - 400012 https://www.kem.edu/
- Funding Source
- No funding Grant number(s) <span style=font-size: 14px>State the funder, grant or award number and the date of award</span> Not applicable
- Other Selection Criteria
- Final Publication
- Same Topic Review
- No
- Published Protocol
- Review Type
- Language
- English
- Country
- India
- Review Stage
- Review Ongoing
- First Submission Date
- 2022-12-01
- Registration Date
- 2022-12-12
- Anticipated Start Date
- 2023-01-02
- Anticipated Completion Date
- 2024-01-01
- Title Cn
- 二甲双胍、肌醇、生活方式改变和草药在改善多囊卵巢综合征患者内分泌和临床指标方面的有效性和安全性比较研究：系统评价和网状Meta分析
- Title En
- Study of comparative effectiveness and safety of metformin, myoinositol, life style changes and herbal medicines in improving endocrine and clinical variables in management PCOS patients a systematic review and a network meta-analysis.
- Bilingual Status
- complete