The effectiveness and safety of treatments used for polycystic ovarian syndrome management in adolescents: a systematic review and network meta-analysis protocolReport as inadecuate

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Systematic Reviews

, 4:125

First Online: 23 September 2015Received: 15 July 2015Accepted: 25 August 2015DOI: 10.1186-s13643-015-0105-4

Cite this article as: Al Khalifah, R.A., Flórez, I.D., Dennis, B. et al. Syst Rev 2015 4: 125. doi:10.1186-s13643-015-0105-4


BackgroundPolycystic ovarian syndrome PCOS is a common reproductive endocrine disease that is seen among adolescent women. Currently, there is limited evidence to support treatment options leading to considerable variation in practice among healthcare specialists. The objective of this study is to review and synthesize all the available evidence on treatment options for PCOS among adolescent women.

Methods-designWe will conduct a systematic review of all randomized controlled trials evaluating the use of metformin, oral contraceptive pills as monotherapy, or as combination with pioglitazone, spironolactone, flutamide, and lifestyle interventions in the treatment of PCOS in adolescent women ages 11 to 19 years. The primary outcome measures are menstrual regulation and change hirsutism scores. The secondary outcome measures include acne scores, prevalence of dysglycaemia, BMI, lipid profile, total testosterone level, and adverse events. We will perform literature searches through Ovid Medline, Ovid Embase, and Cochrane Central Register of Controlled Trials CENTRAL, and gray literature resources. Two reviewers will independently screen titles and abstracts of identified citations, review the full texts of potentially eligible trials, extract information from eligible trials, and assess the risk of bias and quality of the evidence independently. Results of this review will be summarized narratively and quantitatively as appropriate. We will perform a multiple treatment comparison using network meta-analysis to estimate the pooled direct and indirect effects for all PCOS interventions on outcomes if adequate data is available.

DiscussionPCOS treatment poses a clinical challenge to the patients and physicians. This is the first systematic review and network meta-analysis for PCOS treatment in adolescents. We expect that our results will help improve patient care, unify the treatment approaches among specialists, and encourage research for other therapeutic options.

Systematic review registrationPROSPERO CRD42015016148

KeywordsAdolescents Polycystic ovarian syndrome Hirsutism Menstrual irregularity Acne Body mass index Dysglycaemia AbbreviationsBMIbody mass index

DICdeviance information criterion

GRADEGrading of Recommendations Assessment, Development and Evaluation

NIHNational Institutes of Health

NMAnetwork meta-analysis

OCPoral contraceptive pill

PCOSpolycystic ovarian syndrome

RCTrandomized controlled trials

T2DMtype two diabetes mellitus

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Author: Reem A. Al Khalifah - Iván D. Flórez - Brittany Dennis - Binod Neupane - Lehana Thabane - Ereny Bassilious


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