Oral Presentation

Metformin versus OCP in adolescent PCOS girls: an RCT from India.

Sujata Kar (IN)

[Kar] Kar Clinic & Hospital Pvt ltd.

Objective : To assess effectiveness of metformin (insulin sensitizing drug ) vs OCP (combined estrogen & progesterone cytoproterone acetate) in improving clinical , hormonal and metabolic features of PCOS girls from India. Context: Evidence is lacking in support of either drug for adolescent PCOS. Our hypotheses was metformin may work better in Indian population with high prevalence of glucose intolerance and visceral obesity. Patients :Fifty eight PCOS girls (Rotterdam) aged ≥ 11 or menarche of at least 2 years and ≤ 19 years .They were randomised to receive either Metformin 1500 mg per day ( Group I 23) or OCP( Group II 35). Intervention : Anthropometric data and biochemical tests at enrollment and again after six months : BMI, Waist circumference (WC) Hip circumference(HC), waist hip ratio(WHR),Acne score, FG Score ,menstrual History, and FT₄, TSH, Prolactin, Total Testosterone, Lipid Profile ,FBS & 75 gm 2 hr GTT. Main outcome measure : Changes in menstrual pattern, BMI, weight loss, hirsutism , hormonal and metabolic parameters . Study duration: 6 months Results : There was no significant difference between the two groups in pretreatment and post treatment characteristics. Univariate regression analysis to look at improvements post treatment : OCP improved menses(p=0.02), worsened total cholesterol , improved LDL (p= 0.05 ; 0.04). OCP group also increased TG , HDLc, and reduced total testosterone , though not statistically significant. Metformin treatment does not seem to improve any biochemical parameter, however change in BMI, WHR, WC was better than OCP group. Conclusion : Metformin was no better than OCP in improving clinical & metabolic features of adolescent PCOS girls.