Efficacy and safety of metformin and liraglutide combination therapy in comparison with metformin in managing metabolic and endocrine levels of pcos: a systematic review

Polycystic ovarian syndrome (PCOS) is a common endocrine disorder causing various metabolic and endocrine dysfunctions. Research shows that women with PCOS who experience severe symptoms often report a diminished quality of life, largely due to concerns about physical appearance, reproductive challenges, and metabolic health issues. PCOS impacts daily life, highlighting the complex interplay between medical, emotional, and social aspects of the condition. Effective PCOS management improves patients’ health and quality of life. This review compares the efficacy and safety of metformin plus liraglutide versus metformin monotherapy in managing metabolic and endocrine levels in women with PCOS. Articles were systematically retrieved from PubMed, Elsevier, and Scopus databases, complemented by manual searches from inception to 2024. Data were extracted using structured forms, analyzed qualitatively, and evaluated for bias using the Cochrane Risk of Bias Tool 2. The review includes RCTs on women with PCOS, aged 18 years and older, with a BMI of at least 24kg/m². Studies were excluded if they were not original, relied on secondary data, involved animal testing, lacked sufficient information, were non-translatable, contained unextractable data, were duplicates, or assessed metformin against interventions other than liraglutide. Combination therapy demonstrated advantages over monotherapy, where participants showed notable reductions in BMI, waist circumference, and insulin resistance (HOMA-IR). Improvements in lipid profiles were observed, including reductions in LDL and triglyceride levels alongside increases in HDL levels. This systematic review highlights the superior efficacy and manageable safety profile of metformin-liraglutide therapy in managing metabolic and endocrine dysfunctions in women with PCOS. Improvements in key parameters suggest combination therapy as an effective option. While side effects were reported, they were mild to moderate and did not detract from overall advantages. Future research with larger sample sizes and longer durations is warranted to confirm findings and investigate long-term benefits.