Incretin-based therapy use in Polish women with PCOS surged from 2018-2024, expanding beyond diabetes
Background
Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder affecting reproductive-aged women, characterized by hormonal imbalances, ovulatory dysfunction, and often metabolic issues like insulin resistance and obesity. These metabolic comorbidities significantly increase the risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease. While glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GIP/GLP-1 RAs are established for T2DM and obesity, their real-world prescribing patterns and impact in the specific context of PCOS, particularly for weight and cardiometabolic management, remain underexplored. Understanding these trends is crucial for optimizing treatment strategies.
Study Design
Researchers conducted a retrospective cohort study utilizing electronic health records from the LUX MED network in Poland, spanning July 2006 to April 2026. The study included 38,263 adult women with ICD-coded PCOS. The primary analysis focused on women diagnosed with PCOS between 2018 and 2024, evaluating the initiation of GLP-1 RA/GIP-GLP-1 RA therapy within 365 days after their index PCOS diagnosis. Temporal trends in therapy initiation were assessed using unadjusted and multivariable-adjusted logistic regression models, comparing users of incretin-based therapies to those on metformin-only or untreated.
Results
Among the 38,263 women with PCOS, 4557 (11.9%) had a recorded GLP-1 RA/GIP-GLP-1 RA prescription, while 16,381 (42.8%) received metformin. A significant 75.5% of incretin-based therapy users also had metformin co-exposure, contrasting with only 11.5% having a coded diagnosis of type 2 diabetes mellitus. Incretin-based therapy users exhibited a higher recorded BMI (median 31.2 kg/m²) compared to metformin-only users (median 26.3 kg/m²) or untreated women (median 22.1 kg/m²), alongside a greater comorbidity burden (all p < 0.001).
Key Findings
- Incretin-based therapy initiation in women with PCOS rose from 0.14% in 2018 to 5.97% in 2024.
- Calendar year was strongly associated with initiation (adjusted OR 1.64, p < 0.001).
- 11.9% of women with PCOS received a
GLP-1 RA/GIP-GLP-1 RAprescription. - 75.5% of incretin users also received metformin, while only 11.5% had type 2 diabetes.
- Incretin users had significantly higher median BMI (31.2 kg/m²) and greater comorbidity burden.
Why It Matters
This real-world data highlights a significant and rapid shift in PCOS management, indicating that incretin-based therapies like GLP-1 RAs and GIP/GLP-1 RAs are increasingly being prescribed for weight and cardiometabolic benefits beyond traditional type 2 diabetes indications. For individuals with PCOS, this suggests a growing acceptance and potential for these peptides to address the often-challenging weight management and metabolic dysfunctions associated with the condition. While this study doesn't provide specific dosing protocols, the observed trend underscores the practical expansion of these therapies into broader metabolic health applications. Future research is needed to confirm long-term efficacy and safety in this specific population.
pcos
glp-1-ra
gip-glp-1-ra
tirzepatide
semaglutide
obesity