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Polyethylene glycol loxenatide + levonorgestrel-releasing intrauterine system (LNG-IUS) is a combination therapy being investigated for the treatment of endometrial atypical hyperplasia (AEH) in obese women. Polyethylene glycol loxenatide (PEX168) is a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist originally developed for type 2 diabetes. It works by improving insulin sensitivity, inhibiting appetite, and reducing systemic inflammation, which are critical factors in obese patients with AEH. The LNG-IUS is a hormonal device that provides local sustained release of levonorgestrel, a progestogen, directly to the endometrium to counteract the effects of estrogen and promote regression of hyperplasia. This combination approach aims to improve complete response rates and preserve fertility by addressing both the local endometrial pathology and the underlying metabolic drivers of the disease.
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