Evidence map›Paper›PMID 42836929›Full record

SynthesisAdvances in therapy2026

Questionable Evidence for Berberine in Polyendocrine Metabolic Ovarian Syndrome: An Integrity-Based Reappraisal.

Eshani Perera, Evangeline Mantzioris, Lisa Moran, Nicole Scannell, Anthony Villani, Vibhuti Rao, Aya Mousa, Madeline Flannagan, Carolyn Ee

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Advances in therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Eshani PereraSchool of Medicine, Western Sydney University, Locked Bag 1797, Penrith, New South Wales, Australia.
Evangeline MantziorisCollege of Health, Adelaide University, North Terrace, Adelaide, South Australia, Australia.
Lisa MoranMonash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Locked Bag 29, Clayton, Victoria, Australia.
Nicole ScannellSchool of Health, University of the Sunshine Coast, PO Box 5280, Sunshine Coast Mail Centre, Queensland, Australia.
Anthony VillaniSchool of Health, University of the Sunshine Coast, PO Box 5280, Sunshine Coast Mail Centre, Queensland, Australia.
Vibhuti RaoNICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, New South Wales, 2751, Australia.
Aya MousaMonash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Locked Bag 29, Clayton, Victoria, Australia.
Madeline FlannaganDepartment of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Locked Bag 29, Clayton, Victoria, Australia.
Carolyn EeNICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, New South Wales, 2751, Australia. c.ee@westernsydney.edu.au.ORCID http://orcid.org/0000-0002-3363-9199

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPrior systematic reviews suggest that berberine may match or exceed the effects of metformin on metabolic and hormonal outcomes in polyendocrine metabolic ovarian syndrome (PMOS; previously referred to as polycystic ovary syndrome). This review aimed to assess the reported efficacy of berberine and act as an integrity-based reappraisal of available evidence in women with PMOS.

methodsA systematic review was conducted in accordance with PRISMA guidelines and prospectively registered. MEDLINE, EMBASE, the Cochrane Library and CINAHL were searched from inception to October 2025. Randomised controlled trials examining berberine supplementation in women with polycystic ovary syndrome were eligible for inclusion. Outcomes of interest included metabolic, hormonal, and anthropometric measures. All eligible trials underwent independent integrity assessment using two validated frameworks: the Research Integrity in Guidelines and Evidence Synthesis framework and the Trustworthiness in Randomised Controlled Trials checklist. Studies rated as moderate or high risk of compromised integrity were excluded from quantitative synthesis. Authors were contacted for clarification prior to exclusion.

resultsAll four trials (n = 452) that met eligibility criteria were independently rated as high risk for compromised integrity, and were not included in quantitative synthesis. Concerns included absent trial registration, implausible recruitment timelines, and potential duplication of data. No clarifying responses were received. While improvements in insulin resistance, lipid profiles, and androgen markers were reported, these findings cannot be considered reliable given the identified concerns.

conclusionsOur review demonstrates that reliable conclusions regarding the efficacy of berberine in PMOS cannot be drawn from the current evidence base.

Indexed as

BerberineNutritional supplementationPolycystic ovary syndromePolyendocrine metabolic ovarian syndromeResearch integrityRIGIDTRACT

Identifiers

PMID42836929

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.