Introduction: This study was done to evaluate other oral hypoglycemic medications;\nespecially the new ones in the management of PCOS patients as alternatives to the\nstandard medication used for this purpose Metformin. Patients and Methods: 105\npatients were enrolled and randomly distributed into 3 groups according to sequence\nof computer-generated block-random numbers. Each group included 35 patients.\nThis randomized double blind case controlled study was conducted at Tanta University\nHospital from December 1, 2015 to October, 1, 2016. In group A (study group 1)\nthe patients received Pioglitazobe 30 mg once a day for 6 months while in group B\n(study group 2) the patients received Vildagliptin 50mg once daily. In Group C\n(control group) the patients received Metformin 500 mg tds. for 6 months. The clinical\noutcome measures of the study were the improvement in the regularity of the\nmenstrual cycle, the BMI and the improvement in the modified Ferriman-Gallwey\n(F-G) score for hirsutism. The biochemical outcome measures will be the change in\nthe Serum Free testosterone, dehydroepiandrosterone (DHEA), fasting insulin level,\nGlcosylated hemoglobin (Hb A1c) and fasting Low Density Lipoproteins (LDL) levels.\nResults: Pioglitazobe in the study group 1 patients showed a significant reduction\nof BMI (p = 0.016), Ferriman-Gallwey score (p = 0.003), free testosterone level\n(p = 0.003), DHEA level (p = 0.001), fasting insulin level (p = 0.036) and Hb a1c level\n(p = 0.000), and also significant reduction of menstrual irregularities (p = 0.035).\nWhen compared to Metformin in the control group 3, there were significant reduction\nof BMI (p = 0.010), Ferriman-Gallwey score (p = 0.002), free testosterone level\n(p = 0.034), Hb a1c (p = 0.000) level and significant reduction of menstrual irregularities\n(p = 0.004) only. This means that the clinical and metabolic effect of Pioglitazobe\nis better than Metformin in PCOS patients. On the contrary there were disappointing\nresults of the new drug Vildagliptin in group 2; the patients in this group showed significant reduction of BMI (p = 0.001), Ferriman-Gallwey score (p = 0.046)\nand Hb a1c (p = 0.000) level only. Non significant effect on menstrual irregularities\nand non significant reduction of LDL level are noticed. But there is elevation of Ferriman-\nGallwey score, free testosterone level, DHEA level and fasting insulin level.\nConclusion: Pioglitazobe is an effective and safe alternative to Metformin in the management\nof PCOS patient although further studies including larger number of patients\nshould be done while Vildagliptin should be omitted for use in PCOS patients.
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