Comparative effectiveness and safety of acupuncture vs metformin in insulin-resistant polycystic ovary syndrome women: A network meta-analysis of randomized controlled trials
Abstract
Background: The purpose of this study was to conduct a network meta-analysis (NMA) comparing the effectiveness and safety of traditional acupuncture with metformin. This study aims to identify an effective and safe alternative treatment for women with polycystic ovary syndrome (PCOS) complicated by insulin resistance (IR).
Methods: We searched PubMed, EMBASE, Web of Science, Cochrane, ClinicalTrials.gov, and relevant citations for eligible randomized controlled trials (RCTs) published up to August 12, 2024. Data extraction and bias assessment were performed by two independent reviewers, and Bayesian NMA was performed using the GeMTC package, with a random effects model. The NMA compared the effectiveness and safety of acupuncture with metformin which were measured using the Homeostasis Model Assessment Insulin Resistance (HOMA-IR) index, fasting plasma glucose, fasting insulin, and the incidence of adverse events (AEs).
Results: We included 12 RCTs (n = 870). Four RCTs compared acupuncture with metformin, six compared metformin with control interventions (blank control or placebo), and two compared acupuncture with sham acupuncture. Acupuncture (Mean difference (MD): -0.76, 95 % credible interval (CrI): -1.42, -0.03) and metformin (MD: -0.74, 95 % CrI: -1.28, -0.17) significantly reduced the IR level (HOMA-IR). No statistical difference was observed between both treatment methods in improving glucose metabolism; however, acupuncture had fewer AEs (risk ratio: 0.13, 95 % CrI:…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 870 participants or records.
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