Luque-Ramírez Manuel, Escobar-Morreale Héctor Francisco
a Diabetes, Obesity and Human Reproduction Research Group, Department of Endocrinology & Nutrition, Hospital Universitario Ramón y Cajal & Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) , Carretera de Colmenar km 9'1, E-28034 Madrid, Spain +34 91 336 9029 ; +34 91 336 9029 ;
Expert Opin Ther Targets. 2015;19(11):1545-60. doi: 10.1517/14728222.2015.1075511. Epub 2015 Sep 7.
The polycystic ovary syndrome (PCOS) is a common androgen disorder in reproductive-aged women. Excessive biosynthesis and secretion of androgens by steroidogenic tissues is its central pathogenetic mechanism.
The authors review the potential targets and new drugs to treat androgen excess in PCOS. Besides our lab's experience, a systematic search (MEDLINE, Cochrane library, ClinicalTriasl.gov, EU Clinical Trials Register and hand-searching) regarding observational studies, randomized clinical trials, systematic reviews, meta-analyses and patents about this topic was performed.
PCOS has a heterogeneous clinical presentation. It is unlikely that a single drug would cover all its possible manifestations. Available treatments for androgen excess are not free of side effects that are of particular concern in these women who suffer from cardiometabolic risk even without treatment. A precise characterization of the source of androgen excess must tailor antiandrogenic management in each woman, avoiding undesirable side effects.
多囊卵巢综合征（PCOS）是育龄期女性常见的雄激素紊乱疾病。类固醇生成组织中雄激素的过度生物合成和分泌是其核心发病机制。
作者综述了治疗PCOS中雄激素过多的潜在靶点和新药。除了我们实验室的经验外，还针对该主题的观察性研究、随机临床试验、系统评价、荟萃分析和专利进行了系统检索（检索数据库包括MEDLINE、Cochrane图书馆、ClinicalTriasl.gov、欧盟临床试验注册库，并进行了手工检索）。
PCOS具有异质性临床表现。单一药物不太可能涵盖其所有可能表现。现有的雄激素过多治疗方法并非没有副作用，而对于这些即使未经治疗也存在心血管代谢风险的女性来说，副作用尤其令人担忧。必须对雄激素过多的来源进行精确表征，以便为每位女性量身定制抗雄激素治疗方案，避免不良副作用。
