Temporal Trends and Clinical Characteristics of Incretin‐Based Therapy Use in Women With Polycystic Ovary Syndrome: A Real‐World Cohort Study From a Polish Private Healthcare Network

Background Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) and the dual GIP/GLP‐1 receptor agonist tirzepatide are increasingly used for weight and cardiometabolic management, but real‐world prescribing patterns in women with polycystic ovary syndrome (PCOS) remain poorly characterised. Methods We performed a retrospective cohort study of 38 263 adult women with ICD‐coded PCOS in the LUX MED network, Poland, using electronic health records data from July 2006 to April 2026. The primary analysis included women diagnosed with PCOS in 2018–2024 and evaluated prescription‐recorded initiation of GLP‐1 RA/GIP–GLP‐1 RA therapy within 365 days after the index diagnosis. Temporal trends were assessed using logistic regression with unadjusted and multivariable‐adjusted models. Results Overall, 4557 women (11.9%) had a recorded GLP‐1 RA/GIP–GLP‐1 RA prescription and 16 381 (42.8%) received metformin. Among incretin‐based therapy users, 75.5% had metformin co‐exposure, whereas only 11.5% had coded type 2 diabetes mellitus. Recorded BMI was higher among GLP‐1 RA/GIP–GLP‐1 RA users than among metformin‐only or untreated women (median 31.2 vs. 26.3 and 22.1 kg/m 2 ) and greater comorbidity burden (all p < 0.001). Initiation within 365 days rose from 0.14% in 2018 to 5.97% in 2024. Calendar year was strongly associated with initiation (unadjusted OR 1.52, 95% CI, 1.44–1.59; adjusted OR 1.64, 95% CI, 1.56–1.73; both p < 0.001), with consistent results after excluding women with diabetes. Conclusions Incretin‐based therapy use in PCOS increased markedly over time, suggesting expansion beyond classical glycaemic indications toward weight‐focused and cardiometabolic management. Studies using dispensing, persistence, safety and outcome data are needed.