The metabolic benefits associated with semaglutide use in obese women with polycystic ovary syndrome- a retrospective study of clinical practice.

BACKGROUND: Women with polycystic ovary syndrome (PCOS) have a higher prevalence of obesity, which negatively impacts health. Guidelines suggest that GLP1 Receptor Agonists could be considered but highlight a lack of evidence for treatment in PCOS. Reducing body weight by as little as 5% has significant benefits in women with PCOS. AIMS: The aim of this retrospective study was to analyse the metabolic impact of semaglutide use in routine clinical practice in obese women with PCOS. METHODS: Data were collected on 58 women with PCOS and obesity attending reproductive endocrinology clinics and prescribed semaglutide therapy for > 6 months. RESULTS: Mean age was 34.7 ± 6.8 years. Median duration of GLP1 agonist therapy was 12(7-17) months. Mean weight loss was 12.6 ± 9.6 kg (11.4% total body weight, p < 0.0001). 81% of women lost > 5% of their total body weight. Mean BMI reduced from 40.7 ± 6.3 to 36.2 ± 6.7 kg/m² (p < 0.0001). Mean systolic blood pressure reduced by 6.3mmHg (p = 0.012). Median HbA1C reduced from 35.3 (32.8-38.3) to 33 (31-35) mmol/mol (p = 0.0014). Mean total cholesterol reduced from 4.8 ± 0.9 mmol/L to 4.45 ± 0.91 mmol/L, p = 0.03. 50% of those with oligomenorrhoea reported subjective improvement in their menstrual cycles. 33% of those with acne and 29% of those with hirsutism reported improvements in their symptoms. CONCLUSIONS: In this real-world analysis of clinical practice, semaglutide use in obese women with PCOS was associated with significant weight loss, reduced systolic blood pressure, cholesterol and HbA1C.