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19-03-2024 | Progestin | Review

Metformin and progestins in women with atypical hyperplasia or endometrial cancer: systematic review and meta-analysis

Authors: Leila Adamyan, Laura Pivazyan, Sapiyat Isaeva, Roman Shapovalenko, Araksya Zakaryan

Published in: Archives of Gynecology and Obstetrics

Abstract

Purpose

To assess metformin's effectiveness in adding it to progestin-based hormone therapy for treating atypical endometrial hyperplasia (AEH) and early endometrial cancer (EEC).

Methods

We conducted a systematic review and meta-analysis following PRISMA guidelines (registration number CRD42023399094). We searched databases for studies up to March 2023, including randomized and non-randomized clinical trials in English.

Results

Out of 280 studies, 9 studies (1104 patients) were eligible. A total of 408 patients were allocated to receive metformin, and 696 patients entered the control group. Primary analysis focused on evaluating the CR showed a significant difference in patients with AEH treated with metformin (RR = 1.10, 95% CI 1.02−1.20, p = 0.02). Relapse rate (RR = 0.62, 95% CI 0.33−1.17, p = 0.14) was also evaluated. Secondary analysis indicated higher pregnancy rates (RR = 1.28, 95% CI 1.04−1.57, p = 0.02) with no significant difference in live birth rates (RR = 0.56, 95% CI 0.29−1.10, p = 0.09).

Conclusion

Combined therapy is effective. Metformin shows superiority to the standard regimen in achieving better CR rate in patients with AEH and benefits pregnancy rates but not recurrence or live birth rates. Therefore, the ideal fertility-sparing treatment for EC has not yet been determined and further clinical trials are needed.

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Title: Metformin and progestins in women with atypical hyperplasia or endometrial cancer: systematic review and meta-analysis
Authors: Leila Adamyan
Laura Pivazyan
Sapiyat Isaeva
Roman Shapovalenko
Araksya Zakaryan
Publication date: 19-03-2024
Publisher: Springer Berlin Heidelberg
Keywords: Progestin
Metformin
Endometrial Cancer
Endometrial Cancer
Fertility
Published in: Archives of Gynecology and Obstetrics
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-024-07416-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Metformin and progestins in women with atypical hyperplasia or endometrial cancer: systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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