E-news: Low-dose spironolactone and metformin combination in PCOS

Of 204 women who met the 2006 Androgen Excess-PCOS criteria for PCOS, 198 were randomized into three equal groups to receive metformin (1000 mg/d), low-dose spironolactone (50 mg/d), or a combination of both drugs for a period of 6 months.

A total of 169 subjects (n = 56 metformin, 51 spironolactone, 62 combination) completed the study by Mohd Ashraf Ganie et al.

The three groups had comparable mean age and BMI at baseline. By 6 months, menstrual cycles/y increased, whereas Ferriman-Gallwey score, serum total T, and area under the curve-glucose and -insulin decreased significantly (P < .05) in the combination group as compared to either drug alone.

There was no significant change in body weight, BMI, waist-hip ratio, and blood pressure in any of the three groups. The combination group had better compliance than either drug alone, and the adverse event rate was not higher.

The combination of low-dose spironolactone with metformin seems superior to either drug alone in terms of clinical benefits and compliance in women with PCOS.