Abstract Objective To assess the effect of treatment with glucagon-like peptide-1 receptor agonists (GLP1-RAs) on weight-related, metabolic and reproductive outcomes and health economics in women with polycystic ovary syndrome (PCOS). Design Systematic review and meta-analysis, Prospero CRD42024535096 Methods Cochrane Library, EMBASE and Medline was searched on September 20, 2024 for studies including women with PCOS, comparing GLP1-RAs with no treatment, placebo, lifestyle intervention, combined oral contraceptives, antiandrogenic drugs or metformin in randomized controlled trials (RCTs). Results 9654 studies were identified, 365 read in full text and 11 RCTs were included. GLP1-RAs as an add-on showed a reduction in BMI compared to the control group, mean difference (95% confidence interval), -1.38 (-2.39 to -0.38) kg/m2 (low certainty). For LDL cholesterol and triglycerides, no difference was noted between the groups (low certainty), whereas evidence was insufficient to draw conclusion regarding glucose, insulin, hirsutism and menstrual regularity. No studies were identified assessing quality of life, mental health, or cost-effectiveness outcomes. Conclusion GLP-1-RAs are associated with modest short-term weight loss in women with PCOS and overweight or obesity. Evidence for benefits on metabolic, reproductive, or psychological outcomes remains uncertain due to low-quality data, and no studies have evaluated cost-effectiveness.
Forslund et al. (2026) studied this question.