Patients with PCOS achieve weight loss with liraglutide, roflumilast

SAN DIEGO — Women with obesity and polycystic ovary syndrome experienced significant weight loss on short-term monotherapy with liraglutide or roflumilast; however, the effects were greater with liraglutide, according to study findings presented here.

“Weight management by lifestyle intervention and metformin often remains unsatisfactory in obese women with PCOS,” the researchers wrote. “New treatment options for weight reduction acting through glucagon-like peptide-1 mediated effects could be considered in these patients.”

Mojca Jensterle, MD, PhD, and colleagues from the University Medical Centre Ljubljana in Slovenia, conducted a 12-week prospective randomized open-label study on 41 women with obesity and PCOS to determine the effects of liraglutide 1.2 mg once a day, roflumilast 500 mcg once a day or metformin 1,000 mg twice a day on body weight reduction, glucose homeostasis, androgen profile and menstrual frequencies.

Compared with the metformin group, participants assigned liraglutide (P = .006) and roflumilast (P = .002) experienced greater weight loss. BMI also decreased more among participants assigned liraglutide (P = .006) and roflumilast (P-.001) compared with metformin. Liraglutide is classified as a glucagon-like peptide-1 (GLP-1) and roflumilast is classified as a phosphodiesterase-4 (PDE-4) inhibitor.

Superior effects on reducing weight (P - .022), BMI (P = .02) and waist circumference (P = .007) were found with liraglutide compared with metformin. During oral glucose tolerance testing, more favorable glucose homeostasis was found among participants assigned liraglutide.

Compared to baseline, decreases in testosterone (P = .05) and increases in menstrual frequencies (P = .009) were found with roflumilast.

“This is the first study to date that directly compared liraglutide with roflumilast, either in PCOS-related obesity or in any other obese population,” Jensterle told Endocrine Today. “The researchers indicated the place of PDE-4 inhibition as a new potential therapeutic alternative in an obesity-related population in comparison with more conventional antiobesity pharmacologic modalities. Further exploration of the GLP-1-mediated effect of PDE-4 inhibition in metabolic conditions associated with obesity are needed. The additive efficacy of drugs acting through [GLP-1] mediated pathways in combination with a lifestyle intervention and metformin are attractive targets for further investigation.” – by Amber Cox

Reference:

Jensterle M, et al. OR15-4. Presented at: The Endocrine Society Annual Meeting; March 5-8, 2015; San Diego.

Disclosure: The researchers report no relevant financial disclosures.