SGLT2 inhibitor empagliflozin promotes more weight loss than Metformin in PCOS

UK: Women with polycystic ovary syndrome (PCOS) and obesity who received the diabetes drug SGLT2 inhibitor empagliflozin lost more weight and had a lower metabolic rate compared with women who received metformin, according to a recent study. Although no changes were seen in hormonal or metabolic parameters.

The study, published in the journal Clinical Endocrinology, found that among women with PCOS and obesity those who received empagliflozin therapy for 12 weeks showed significant improvement in anthropometric parameters (weight, body mass index, hip circumference, waist circumference, and fat mass) and body composition.

Empagliflozin is a sodium-glucose-cotransporter-2 inhibitor that promotes weight loss and improves cardiovascular risk in type 2 diabetes patients. PCOS is a hormonal disorder that causes obesity and increases the risk of cardiovascular disease. Therefore, empagliflozin may be of benefit for these women.

For the purpose, they conducted a randomized open-label study in women with PCOS. They were randomized to receive either empagliflozin 25 mg (n = 19) or metformin 1500 mg (n = 20) daily for 12 weeks. The main outcomes assessed were changes in anthropometric and body composition, hormonal and metabolic parameters.

Key findings of the study include:

• Compared with participants in the metformin group, researchers observed greater percentage changes from baseline for participants in the empagliflozin group for body weight (mean, 1.2% vs. –1.4%); BMI (mean, 1.1% vs. –1.4%;), waist circumference (mean, 0.2% vs. –1.6%) and hip circumference (mean, 1.1% vs. –2%).


• Similar findings were obtained between-group differences between the metformin and empagliflozin groups for basal metabolic rate (mean, 0.1% vs. –1.8%) and fat mass (mean, 3.2% vs. –0.7%).


• Women in the empagliflozin group also experienced increases in levels of sex hormone-binding globulin and estradiol at 12 weeks; however, researchers observed no other hormonal changes for either group.


• There were no changes observed for either treatment arm at 12 weeks for blood pressure, endothelial function, insulin sensitivity or lipid profile.

"There was a significant improvement in anthropometric parameters and body composition, in overweight and obese women with PCOS after 12 weeks of treatment with empagliflozin compared to metformin, although no changes were seen in hormonal or metabolic parameters," concluded the authors.