Tier 2 — strong

Comparative efficacy of oral insulin sensitizers metformin, thiazolidinediones, inositol, and berberine in improving endocrine and metabolic profiles in women with PCOS: a network meta-analysis

Zhao H, Xing C, Zhang J, He B

Reproductive health 2021 18(1):171

Bibliography

PubMed: PMID 34407851
PubMed Central: PMC8371888
DOI: 10.1186/s12978-021-01207-7
Funding: Indexed support: 345 Talent Project of ShengJing Hospital of China Medical University; National Natural Science Foundation of China. See the publication for grant details.
Competing interests: The authors declared no competing interests in the publication.

Design	Systematic review and meta-analysis
Model	Published human studies
Sample	22 trials; 1079 participants across several insulin sensitizers
Intervention	Evidence synthesis; interventions and comparators vary across included studies
Duration	No new treatment; included-study durations vary
Endpoints	Pooled clinical or metabolic outcomes; Risk of bias and heterogeneity; Adverse-event reporting

The network analysis compared several agents and combinations, with much of the apparent advantage belonging to non-berberine regimens.

The network analysis compared several agents and combinations, with much of the apparent advantage belonging to non-berberine regimens.

Indirect network rankings are not head-to-head proof. Trial trustworthiness and transitivity assumptions matter.

Editorial review

Last verified 22 October 2026