Cai M, Shao X, Xing F, et al. - A single center, prospective, randomized open-label (ratio 1:1) non-inferiority trial comparing the safety and efficacy of canagliflozin vs metformin in polycystic ovary syndrome (PCOS) patients with insulin resistance (IR).

• Researchers administered either 100 mg (n = 33) canagliflozin daily or 1,500–2,000 mg metformin daily (n = 35) for 12 weeks to women aged 18–45 years with PCOS and IR.

• Outcomes suggest non-inferiority of canagliflozin to metformin in lowering of HOMA-IR after 12 weeks of treatment.

• Significant improvement in menstrual pattern, reduction in body weight and total fat mass, and lowering of triglyceride levels could be achieved by administering with both canagliflozin and metformin.

• There were significant advantages in reducing uric acid and dehydroepiandrosterone sulfate levels in correlation with providing canagliflozin vs metformin.

• The main adverse events in the metformin group and canagliflozin group were pruritus vulvae (9.09%) and gastrointestinal reaction (55.55%), respectively.

• In view of the noninferiority of canagliflozin to metformin in PCOS patients with IR, researchers herein support considering sodium-glucose co-transporter 2 inhibitors as effective drugs in the treatment of PCOS patients with IR.