Endocrine Abstracts

Context: Rimonabant has been found to reduce weight and improve the metabolic profile in patients with metabolic syndrome as well as PCOS.

Objective: To compare the effects of metformin and rimonabant in patients with PCOS with and without metabolic syndrome according to ATP III criteria.

Design: A randomised open labelled parallel study comparing the effects on rimonabant and metformin in patients with PCOS.

Subjects: Twenty patients with PCOS with a BMI≥30 kg/m² were included. There were 7 patients in the rimonabant group with metabolic syndrome compared to 5 patients in metformin group. Patients were randomised to metformin 1.5 g daily or rimonabant 20 mg daily. Anthropometric parameters, HOMA-IR, free androgen index (FAI), lipid profile and blood pressure were compared before and after treatment in both groups.

Results: After treatment only 4 patients had metabolic syndrome in rimonabant group and 4 patients in metformin group. There was significant improvement in weight (kg) (Mean(S.E.M.) P value) (98(4.4) vs 91.2(4.2)0.02), waist circumference (cm) (114(3.5) vs 106.6(10.3) 0.02), testosterone (nmol/l) (4.7(0.7) vs 3.1(0.4) 0.02) and FAI (30.7(5.5) vs 19.1(5.0) 0.02) in patients who had metabolic syndrome in rimonabant group while there was no improvement in any of these parameters in patients without metabolic syndrome. There was no improvement in any of these parameters in patients who were on metformin with or without metabolic syndrome. There were no changes in any of the other parameters.

Conclusion: There was a significant improvement in weight and hyperandrogenemia in PCOS patients with metabolic syndrome treated with rimonabant compared to patients without metabolic syndrome over a period of 3 months.