Dipeptidyl Peptidase-4 Inhibitor Sitagliptin Prevented Weight Regain in Obese Women with Polycystic Ovary Syndrome Previously Treated with Liraglutide: A Pilot Randomized Study

Background: Weight loss is often nonsustainable after liraglutide cessation. The present study is the first insight into the potential prevention of weight regain in obese subjects who have been withdrawn from liraglutide. We evaluated whether dipeptidyl peptidase-4 (DPP-4) inhibitor sitagliptin in adjunct to metformin prevents body weight regain more effectively than metformin alone in obese polycystic ovary syndrome (PCOS) previously treated with liraglutide. Methods: A 12-week prospective randomized open-label study was conducted with 24 obese women with PCOS who had been pretreated with liraglutide 3.0mg due to antiobesity management (aged 34.36.8 years, body mass index [BMI] 36.35.2kg/m(2), mean +/- standard deviation). They were randomized to combined treatment (COMBO) with sitagliptin 100mg per day (QD) and metformin (MET) 1000mg twice daily (BID) (n=12) or MET 1000mg BID (n=12). Lifestyle intervention was promoted in both groups. The primary outcome was change in anthropometric measures of obesity. Results: Women treated with MET regain 4.7 +/- 2.7kg (P=0.002) compared with a 0.9 +/- 2.5kg in COMBO (P=0.147). BMI increased for 1.7 +/- 0.9kg/m(2) in MET (P=0.002) compared with 0.3 +/- 0.8kg/m(2) increase in COMBO (P=0.136). MET group regain 4.5%+/- 2.5% of body weight as opposed to 0.8%+/- 2.6% in COMBO. The between-treatment differences were significant for weight change (P<0.001), percentage of weight change (P<0.001), and BMI change (P<0.001). Greater ability to resist emotional eating was demonstrated in COMBO. Conclusion: Sitagliptin in adjunct to metformin prevented weight regain in obese women with PCOS previously treated with liraglutide.