A compound against malaria, possible treatment for polycystic ovary syndrome

A recent study published in the journal Science, has revealed that a derivative of the artemisia plant, known for its antimalarial properties, could be effective in treating polycystic ovary syndrome (PCOS). This hormonal disorder is the most common in women of a reproductive age, affecting up to 13%. It is characterised by an excessive production of androgens, a group of hormones that includes testosterone. It also leads to alterations in the ovulatory cycle and an increase in the number of follicles (structures in which the eggs develop). Women with PCOS also have an increased risk of obesity, insulin resistance, other metabolic problems and infertility. 

The research was carried out at the Fudan University in Shanghai and included experiments on animals and a pilot clinical trial of 19 women. It was observed that an artemisinin derivative reduced the production of androgens and improved the main disorders associated with PCOS. 

Gemma Casals, a gynaecologist specialising in reproductive medicine at the Hospital Clínic Barcelona, stated that, "The interest in this research lies not only in the fact that this substance reverses the main disorders of this syndrome, but, by studying its mechanism of action, our knowledge of the pathophysiology of PCOS has been deepened.”  

The PCOS animal model has certain limitations. Therefore, the authors carried out a pilot study in women and managed to reproduce the changes observed in the mouse: with only 12 weeks of treatment, significant changes were observed in the participating women. Improvements were seen in hormonal analyses, the regularisation of the menstrual cycle and the ovarian follicle count. "The next step is for its safety and effectiveness to be tested in larger groups of patients; for periods longer than 12 weeks; and in women with different clinical presentations of PCOS (e.g. obese women). Finally, it must be determined if the positive effects on fertility observed in the animal model are also confirmed.” clarifies Dr Casals. 

PCOS Research at Clínic Barcelona

A recent study carried out by the Clinic-IDIBAPS demonstrated an improvement in the hormonal changes of women with PCOS and obesity after bariatric surgery, similar to those observed in research with artemisinin. Bariatric surgery for the treatment of obesity entails radical metabolic changes in a woman's body, especially those with PCOS. However, the effectiveness of artemisinin derivatives has not yet been established in women with PCOS and obesity. 

In addition, Dr Casals added, "At the Clínic Barcelona, we have not yet investigated artemisinin derivatives; however, we have found promising results from studying the impact of supplementing certain vitamins, antioxidants and probiotics on women with PCOS before carrying out an in vitro fertilisation cycle.”  

Current PCOS treatment 

All women with PCOS are recommended to follow a healthy lifestyle; both to improve their symptoms and to reduce cardiovascular risk and metabolic problems, such as obesity and type 2 diabetes.  

The current main pharmacological treatments for PCOS - hormonal contraceptives, metformin and antiandrogenic drugs - focus on alleviating the symptoms, but do not address the cause of the disorder.  

For this reason, this study with artemisinin provides promising initial results. Artemisinin reduces the production of androgens in the ovaries and thus addresses a key aspect in the development of this disorder and represents an alternative to current symptomatic treatments. Nevertheless, more studies are still needed to confirm these findings and determine the optimal dose and duration of treatment. 

INFORMATION DOCUMENTED BY:  

Dr Gemma Casals, Gynaecology Department at Hospital Clínic Barcelona.