Evidence mapPaperPMID 41862977Full record

ArticleJournal of ovarian research2026

The efficacy and safety of novel antidiabetic agents in polycystic ovary syndrome: a network meta-analysis.

Junjie Lin, Rongtao Yang, Jiacheng Zhuang, Wenbo Zhang, Qiang Tong, Jiahui Liu, Ye Kang, Yuan Yuan

Abstract readNetwork Meta-Analysis
In one paragraph

Article in Journal of ovarian research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Junjie Lin *Department of Clinical Pharmacy, General Hospital of Northern Theater Command, Shenyang, 110016, China.
Rongtao Yang *The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou Province, School of Parmaceutical Sciences, Guizhou Medical University, Guiyang City, Guizhou, 561113, China.
Jiacheng ZhuangDepartment of Clinical Pharmacy, General Hospital of Northern Theater Command, Shenyang, 110016, China.
Wenbo ZhangDepartment of Clinical Pharmacy, General Hospital of Northern Theater Command, Shenyang, 110016, China.
Qiang TongDepartment of Clinical Pharmacy, General Hospital of Northern Theater Command, Shenyang, 110016, China.
Jiahui LiuDepartment of Clinical Pharmacy, General Hospital of Northern Theater Command, Shenyang, 110016, China.
Ye KangDepartment of Clinical Pharmacy, General Hospital of Northern Theater Command, Shenyang, 110016, China.
Yuan YuanDepartment of Clinical Pharmacy, General Hospital of Northern Theater Command, Shenyang, 110016, China. yuanyuan19871207@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPolycystic ovary syndrome (PCOS) is characterised by insulin resistance and hyperandrogenism; whether novel antidiabetic drugs differentially improve these metabolic and reproductive disturbances remains uncertain. We performed a network meta-analysis to simultaneously rank the efficacy and safety of sodium–glucose cotransporter-2 inhibitors (SGLT-2i), GLP-1 receptor agonists (GLP-1RAs) and DPP-4 inhibitors (DPP-4i) in women with PCOS.

methodsWe searched PubMed, Web of Science, Medline, Cochrane CENTRAL and Embase to 6 June 2025 for randomized controlled trials (RCTs) that compared SGLT-2i, GLP-1RAs or DPP-4i with placebo or active drugs in women ≥ 18 years with PCOS. Primary endpoints were Body Mass Index (BMI), homeostasis model assessment of insulin resistance (HOMA-IR), total testosterone (TT) and free androgen index (FAI); secondary endpoints included waist circumference (WC), Sex Hormone Binding Globulin (SHBG), fasting blood glucose (FBG), lipids and gastrointestinal adverse events. A frequentist random-effects network meta-analysis was conducted in Stata 15.1; treatments were ranked with SUCRA (0–100%) and certainty was appraised with CINeMA.

results29 RCTs (1771 participants) were eligible. SGLT-2i yielded the largest reduction in BMI (mean difference vs. placebo − 4.26 kg m⁻², 95% CI − 6.01 to − 2.52; SUCRA 91%) and HOMA-IR (–2.56, − 4.53 to − 0.59; SUCRA 89%). The metformin plus GLP-1RAs combination produced the greatest decrease in TT (–1.35 ng mL⁻¹ vs. placebo, − 2.22 to − 0.48; SUCRA 85%) and FAI (–1.91, − 3.43 to − 0.40; SUCRA 82%), and also led improvements in WC, SHBG and FBG. SGLT-2i ranked first for lowering triglycerides (TG) and total cholesterol (TC). GLP-1RAs monotherapy carried the highest risk of nausea (OR 6.26–9.20), vomiting (OR up to 26.56) and abdominal pain, whereas metformin/DPP-4i markedly increased diarrhoea (OR 2 704 vs. placebo). No statistical inconsistency or publication bias was detected; certainty was high for selected contrasts but moderate to very low for most comparisons.

conclusionsSGLT-2i provide the most favourable cardiometabolic profile as single agents for weight and insulin resistance in PCOS, whereas metformin combined with GLP-1RAs most effectively attenuates hyperandrogenism at the price of greater gastrointestinal intolerance. The low certainty of much of the evidence underscores the need for large, long-term RCTs to confirm these findings. SYSTEMATIC REVIEW REGISTRATION: CRD420251045700.

Indexed as

Hypoglycemic AgentsPolycystic Ovary SyndromeFemaleGlucagon-Like Peptide-1 Receptor AgonistsHumansInsulin ResistanceRandomized Controlled Trials as TopicSodium-Glucose Transporter 2 InhibitorsTreatment OutcomeGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsDPP-4iGLP-1RAsMetforminPolycystic ovary syndromeSGLT-2i

Identifiers

PMID41862977
PMCPMC13126963

What Socratic holds

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.