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

Objective: To systematically evaluate the efficacy and safety of ethinylestradiol cyproterone acetate(Diane-35)and deoxyprogestrel(Marvelon)in the treatment of polycystic ovary syndrome(PCOS).Methods:Randomized controlled trials(RCTS)on the treatment of polycystic ovary syndrome(PCOS)by Diane-35 and Marvelon in PubMed,Cochrane Library,Embase,Web of Science,CNKI,VIP,CBM and other databases were searched by computer system.The literature retrieval time was from the database establishment time to December 2018.Literature was screened,data was extracted and the risk of bias was evaluated according to the Cochrane systematic evaluation method,and the data were statistically analyzed using the RevMan5.3 software.Results: A total of 13 RCTS were included,with a total of 1020 patients(Diane-35 group,n=509).The Marvelon group,n=511).The results of meta-analysis were as follows :(1)testosterone(T)[SMD=-1.37,95%CI=(-2.20,-0.54),P=0.001)and luteinizing hormone(LH)[SMD=-2.35,95%CI =(-3.80,-0.91),P=0.001)levels in patients with PCOS in the Diane-35 group were better than those in the Marvelon group.(2)the level of sex hormone binding globulin(SHBG)in patients with PCOS increased in the Diane-35 group was better than that in the Marvelon group [SMD=0.66,95%CI =(0.33,1.00),P=0.0001].(3)in terms of improving PCOS patients’ hairy symptoms [RR=1.92,95%CI =(1.01,3.63),P=0.05],[MD=-2.75,95%CI =(-4.81,10.68),P=0.009],Diane-35 group was superior to Marvelon group.(4)Compared with Marvelon group,Diane-35 group had less adverse reactions[RR=0.30,95%CI =(0.11,0.78),P=0.01].(5)There was no significant difference in other data between the two groups,including:follicle stimulating hormone(FSH)[SMD=0.33,95%CI =(-0.11,0.77),P=0.14],LH/FSH[MD=-0.91,95%CI=(-3.36,1.54),P=0.47],estradiol(E2)[MD=-1.16,95%CI=(-10.70,8.38),P=0.81],amenorrhea symptom improvement [RR=1.26,95%CI =(0.90,1.76),P=0.18],acne [RR=1.26,95%CI =(0.82,1.94),P=0.29],body mass index(BMI)[MD=-0.10,95%CI =(-0.49,0.30),P=0.62],waist to hip ratio(WHR)[MD=-0.00,95%CI =(-0.01,0.01),P=1.00],homeostasis model assessment of insulin resistance(HOMA-IR)[MD=0.37,95%CI=(-0.53,2.27),P=0.70].Conclusion: Compared with Marvelon,Diane-35 treatment for patients with polycystic ovary syndrome can better improve patients’ hyperluteinizing hormone,hyperandrogenemia and hairy symptoms,with good safety.