BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and the dual GIP/GLP-1 receptor agonist tirzepatide are increasingly used for weight and cardiometabolic management, but real-world prescribing patterns in women with polycystic ovary syndrome (PCOS) remain poorly characterised.
METHODS: We performed a retrospective cohort study of 38 263 adult women with ICD-coded PCOS in the LUX MED network, Poland, using electronic health records data from July 2006 to April 2026. The primary analysis included women diagnosed with PCOS in 2018-2024 and evaluated prescription-recorded initiation of GLP-1 RA/GIP-GLP-1 RA therapy within 365 days after the index diagnosis. Temporal trends were assessed using logistic regression with unadjusted and multivariable-adjusted models.
RESULTS: Overall, 4557 women (11.9%) had a recorded GLP-1 RA/GIP-GLP-1 RA prescription and 16 381 (42.8%) received metformin. Among incretin-based therapy users, 75.5% had metformin co-exposure, whereas only 11.5% had coded type 2 diabetes mellitus. Recorded BMI was higher among GLP-1 RA/GIP-GLP-1 RA users than among metformin-only or untreated women (median 31.2 vs. 26.3 and 22.1 kg/m) and greater comorbidity burden (all p < 0.001). Initiation within 365 days rose from 0.14% in 2018 to 5.97% in 2024. Calendar year was strongly associated with initiation (unadjusted OR 1.52, 95% CI, 1.44-1.59; adjusted OR 1.64, 95% CI, 1.56-1.73; both p < 0.001), with consistent results after excluding women with diabetes. 2
CONCLUSIONS: Incretin-based therapy use in PCOS increased markedly over time, suggesting expansion beyond classical glycaemic indications toward weight-focused and cardiometabolic management. Studies using dispensing, persistence, safety and outcome data are needed.
