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N-acetylcysteine for polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled clinical trials.

Thakker D, Raval A, Patel I, Walia R - Obstet Gynecol Int (2015)

Bottom Line: There was no significant difference in rates of the miscarriage, menstrual regulation, acne, hirsutism, and adverse events, or change in body mass index, testosterone, and insulin levels with NAC as compared to placebo.Conclusions.NAC showed significant improvement in pregnancy and ovulation rate as compared to placebo.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacology, SAL Institute of Pharmacy, Ahmadabad, Gujarat 380060, India.

ABSTRACT
Objective. To review the benefits and harms of N-acetylcysteine (NAC) in women with polycystic ovary syndrome (PCOS). Method. Literature search was conducted using the bibliographic databases, MEDLINE (Ovid), CINAHL, EMBASE, Scopus, PsyInfo, and PROQUEST (from inception to September 2013) for the studies on women with PCOS receiving NAC. Results. Eight studies with a total of 910 women with PCOS were randomized to NAC or other treatments/placebo. There were high risk of selection, performance, and attrition bias in two studies and high risk of reporting bias in four studies. Women with NAC had higher odds of having a live birth, getting pregnant, and ovulation as compared to placebo. However, women with NAC were less likely to have pregnancy or ovulation as compared to metformin. There was no significant difference in rates of the miscarriage, menstrual regulation, acne, hirsutism, and adverse events, or change in body mass index, testosterone, and insulin levels with NAC as compared to placebo. Conclusions. NAC showed significant improvement in pregnancy and ovulation rate as compared to placebo. The findings need further confirmation in well-designed randomized controlled trials to examine clinical outcomes such as live birth rate in longer follow-up periods. Systematic review registration number is CRD42012001902.

No MeSH data available.


Related in: MedlinePlus

PRISMA flow diagram for selection of studies for the systematic review. Flow diagram style adapted from Moher et al. [12].
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fig1: PRISMA flow diagram for selection of studies for the systematic review. Flow diagram style adapted from Moher et al. [12].

Mentions: We retrieved 191 articles (MEDLINE: 9, The Cochrane library: 7, PsycINFO: 0, Scopus: 90; CINAHL: 26; ISO-Web of Science: 18; ProQuest: 38, and 3 citations using conference proceedings and hand-searching of journals). Two studies were excluded due to lack of a control group and had a prepost study design for evaluating treatment [13, 27]. After excluding narrative reviews, nonrandomized studies, intervention studies on agents other than NAC, and duplicate publications, we included eight studies (eight articles) [14, 17–22, 28]. Figure 1 describes the selection procedures for eight studies using the PRISMA flow diagram.


N-acetylcysteine for polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled clinical trials.

Thakker D, Raval A, Patel I, Walia R - Obstet Gynecol Int (2015)

PRISMA flow diagram for selection of studies for the systematic review. Flow diagram style adapted from Moher et al. [12].
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4306416&req=5

fig1: PRISMA flow diagram for selection of studies for the systematic review. Flow diagram style adapted from Moher et al. [12].
Mentions: We retrieved 191 articles (MEDLINE: 9, The Cochrane library: 7, PsycINFO: 0, Scopus: 90; CINAHL: 26; ISO-Web of Science: 18; ProQuest: 38, and 3 citations using conference proceedings and hand-searching of journals). Two studies were excluded due to lack of a control group and had a prepost study design for evaluating treatment [13, 27]. After excluding narrative reviews, nonrandomized studies, intervention studies on agents other than NAC, and duplicate publications, we included eight studies (eight articles) [14, 17–22, 28]. Figure 1 describes the selection procedures for eight studies using the PRISMA flow diagram.

Bottom Line: There was no significant difference in rates of the miscarriage, menstrual regulation, acne, hirsutism, and adverse events, or change in body mass index, testosterone, and insulin levels with NAC as compared to placebo.Conclusions.NAC showed significant improvement in pregnancy and ovulation rate as compared to placebo.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacology, SAL Institute of Pharmacy, Ahmadabad, Gujarat 380060, India.

ABSTRACT
Objective. To review the benefits and harms of N-acetylcysteine (NAC) in women with polycystic ovary syndrome (PCOS). Method. Literature search was conducted using the bibliographic databases, MEDLINE (Ovid), CINAHL, EMBASE, Scopus, PsyInfo, and PROQUEST (from inception to September 2013) for the studies on women with PCOS receiving NAC. Results. Eight studies with a total of 910 women with PCOS were randomized to NAC or other treatments/placebo. There were high risk of selection, performance, and attrition bias in two studies and high risk of reporting bias in four studies. Women with NAC had higher odds of having a live birth, getting pregnant, and ovulation as compared to placebo. However, women with NAC were less likely to have pregnancy or ovulation as compared to metformin. There was no significant difference in rates of the miscarriage, menstrual regulation, acne, hirsutism, and adverse events, or change in body mass index, testosterone, and insulin levels with NAC as compared to placebo. Conclusions. NAC showed significant improvement in pregnancy and ovulation rate as compared to placebo. The findings need further confirmation in well-designed randomized controlled trials to examine clinical outcomes such as live birth rate in longer follow-up periods. Systematic review registration number is CRD42012001902.

No MeSH data available.


Related in: MedlinePlus