Comparison Of Drospirenone Ethinylestradiol And Ethinylestradiol Cyproterone Acetate In Women With Polycyystic Ovarian Syndrome:a Meta-analysis

OBJECTIVES: To compare the efficacy and safety of drospirenone ethinylestradiol(EE/DRSP)and ethinylestradiol cyproterone acetate(EE/CPA)for polycystic ovary syndrome(PCOS).METHODS: A meta-analysis was conducted on the RCTs searched through Cochrane Library,Pubmed,Embase,CNKI,Wanfang database and Vip database.Risk of bias was assessed by the Cochrane Collaboration’s tool and meta-analysis were performed using Revman 5.3 software.RESULTS: A total of 10 eligible trials with 687 patients were included in this review.The meta-analysis showed no statistically significant differences in efficacy on acne,systolic blood pressure(SBP),diastolic blood pressure(DBP),follicle stimulating hormone(FSH),luteinizing hormone(LH)and LH/FSH between EE/DRSP and EE/CPA(P>0.05).There was no significant change in waist-hip ratio(WHR)and body mass index(BMI)before and after treatment in both groups.EE/CPA was superior to EE/DRSP in reducing Ferriman-Galllwey(FG)score,increasing sex hoemone-binding globulin(SHGB).But they showed equal efficacy on total testosterone(T)and free androgen index(FAI)(P>0.05).Both groups increased total cholesterol(TC),total triglycerides(TG),high-density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)level in patients with PCOS,but EE/CPA increased more evidently on TC and LDL-C(P=0.0005,P<0.0001).Both two groups increased fasting blood-glucose(FBG),fasting insulin(FINS)and homeostasis model assessment of insulin resistance(HOMA-IR),but EE/DRSP seemed be less harm.It showed no difference in the incidence of adverse events between EE/DRSP and EE/CPA(P=0.94).CONCLUSIONS: Both EE/DRSP and EE/CPA could significantly reduce hyperandrogenemia,adjust endocrine disorder in PCOS patients.EE/CPA was better in treating hirsutism,but EE/DRSP was less harm to lipid metabolism.Two groups were similar in safety.