Reviewer ’s report  
 
Title: Comparative Efficacy of Statins, Metformin, S pironolactone and Combined Oral 
Contraceptives in Reducing Testosterone Levels in Women with Polycystic Ovary  Syndrome: A 
network meta -analysis of randomized clinical trials.  
 
Version: 0 Date: 27 Jan 2020  
 
Reviewer: Fu-Jen Huang  
 
Reviewer's report:  
 
Dear authors  
 
The manuscript entitled " Comparative Efficacy of Statins, M etformin, Spironolactone and 
Combined Oral Contraceptives in Women with Polycystic overy Syndrome: A network meta -
analysis of randomized clinical trials." has been submitted for the journal. The analytic methods 
and paper writing are well done. However, th e discussion needs to be re -writed.  
 
 
Questions:  
 
The conclusions as "Moderate to high intensity statins alone found to be more effective than the 
other management strategy in reducing the total testosterone level for the patients with PCOS" 
were shown in th e manuscript. The authors need to add some relative papers to discuss above 
conclusions. What are the similarities and differences in comparison with these papers?  
 
 
For example:  
 
1. Cassidy -Vu L et al., Role of statin drugs for polycystic ovary syndrome. Jou rnal of 
family and reproductive health .2016  
 
2. Yang S et al., The effect of statins on level of dehydroepiandrosterone (DHEA) in women 
with polycystic ovary syndrome: a systematic review and meta -analysis. Med Sci Monit 
2019.  
 
3. Puurunen J et al., Statin therapy worsens insulin sensitivity in women with polycystic 
ovary syndrome (PCOS): a prospective, randomized, double -blind, placebo -controlled 
study. J Clin Endocrinol Metab 2013.  
 
4. Gao L et al., Statin is a reasonable treatment option for patients with polycystic ovary 
syndrome: a meta -analysis of randomized controlled trials. Exp CLin Endomcrinol 
Diabetes 2012.  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
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