Goldberg, A.Graca, S.Liu, J.Rao, V.Witchel, S.F.Pena, A.Li, R.Mousa, A.Tay, C.T.Pattuwage, L.Teede, H.Yildiz, B.O.Ee, C.2024-09-032024-09-032024Obesity Reviews, 2024; 25(5):e13704-1-e13704-231467-78811467-789Xhttps://hdl.handle.net/2440/142130This systematic review and meta-analysis evaluated the efficacy of anti-obesity agents for hormonal, reproductive, metabolic, and psychological outcomes in polycystic ovary syndrome (PCOS) to inform the 2023 update of the International Evidence-based Guideline on PCOS. We searched Medline, EMBASE, PsycInfo, and CINAHL until July 2022 with a 10-year limit to focus on newer agents. Eleven trials (545 and 451 participants in intervention and control arms respectively, 12 comparisons) were included. On descriptive analyses, most agents improved anthropometric outcomes; liraglutide, semaglutide and orlistat appeared superior to placebo for anthropometric outcomes. Meta-analyses were possible for two comparisons (exenatide vs. metformin and orlistat + combined oral contraceptive pill [COCP] vs. COCP alone). On meta-analysis, no differences were identified between exenatide versus metformin for anthropometric, biochemical hyperandrogenism, and metabolic outcomes, other than lower fasting blood glucose more with metformin than exenatide (MD: 0.10 mmol/L, CI 0.02-0.17, I2  = 18%, 2 trials). Orlistat + COCP did not improve metabolic outcomes compared with COCP alone (fasting insulin MD: -8.65 pmol/L, -33.55 to 16.26, I2  = 67%, 2 trials). Published data examining the effects of anti-obesity agents in women with PCOS are very limited. The role of these agents in PCOS should be a high priority for future research.en© 2024 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.anti-obesity agents; GLP1 receptor agonists, meta-analysis; polycystic ovary syndromeHumansPolycystic Ovary SyndromeMetforminContraceptives, Oral, CombinedAnti-Obesity AgentsHypoglycemic AgentsFemaleExenatideOrlistatJournal article10.1111/obr.137042024-09-03685280Pena, A. [0000-0002-6834-4876]