Cabergoline versus bromocriptine in the treatment of hyperprolactinemia: a systematic review of randomized controlled trials and meta-analysis

Nunes, Vânia dos Santos; Dib, Regina El; Boguszewski, César Luiz; Nogueira, Célia Regina

doi:10.1007/s11102-010-0290-z

Cited by 99 publications

(60 citation statements)

References 26 publications

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“…These females are overweight, infertile, and anovulatory and have profound alterations in the reproductive endocrine axis (23). In the present study, we found that hyperprolactinemia was essential for the phenotypic defects of the hCGβ+ females because most of them were reversed by treatment with dopamine agonists with proven efficacy in hyperprolactinemia (16, 17, 20, 35). …”

Section: Discussionmentioning

confidence: 53%

“…Of them, bromocriptine has been used over the past 30 yr, but a considerable number of patients are resistant to this treatment, and it has multiple side effects (12, 13). Cabergoline provides an alternative often with better results (14–16), and the ovulatory cycle and fertility can be recovered after cabergoline treatment in patients with hyperprolactinemia due to macro- or microprolactinomas (17). In addition, cabergoline administration to female rats prevents embryo implantation due to a deficiency in progesterone production (18).…”

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confidence: 99%

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Short-Term Pharmacological Suppression of the Hyperprolactinemia of Infertile hCG-Overproducing Female Mice Persistently Restores Their Fertility

et al. 2012

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Female infertility is often associated with deregulation of hormonal networks, and hyperprolactinemia is one of the most common endocrine disorders of the hypothalamic-pituitary axis affecting the reproductive functions. We have shown previously that transgenic female mice overexpressing human chorionic gonadotropin β-subunit (hCGβ+ mice), and producing elevated levels of bioactive LH/hCG, exhibit increased production of testosterone and progesterone, are overweight and infertile, and develop hyperprolactinemia associated with pituitary lactotrope adenomas in adult age. In the present study, we analyzed the influence of the hyperprolactinemia of hCGβ+ females on their reproductive phenotype by treating them with the dopamine agonists, bromocriptine and cabergoline. Long-term bromocriptine treatment of adult mice was effective in the control of obesity, pituitary growth, and disturbances in the hormone profile, demonstrating that hyperprolactinemia was the main cause of the hCGβ+ female phenotype. Interestingly, short-term treatment (1 wk) with cabergoline applied on 5-wk-old mice corrected hyperprolactinemia, hyperandrogenism, and hyperprogesteronemia, prevented pituitary overgrowth, normalized gonadal function, and recovered fertility of adult hCGβ+ females after hormone-induced and natural ovulation. The same cabergoline treatment in the short term applied on 3-month-old hCGβ+ females failed to recover their reproductive function. Hence, we demonstrated that the short-term cabergoline treatment applied at a critical early stage of the phenotype progression effectively prevented the hyperprolactinemia-associated reproductive dysfunction of hCG-overproducing females.

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Section: Discussionmentioning

confidence: 53%

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confidence: 99%

Short-Term Pharmacological Suppression of the Hyperprolactinemia of Infertile hCG-Overproducing Female Mice Persistently Restores Their Fertility

et al. 2012

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“…It has been proven that treatment of hyperprolactinaemia in menopausal women improves their bone mineral density (BMD) [61, 62]. The results of the studies were confirmed in the group of men with hyperprolactinaemia [63, 64]. It was noticed that the patients who received dopaminergic agonist drugs obtained an increase in BMD.…”

Section: Hyperprolactinaemia During the Menopausementioning

confidence: 97%

Hyperprolactinaemia – a problem in patients from the reproductive period to the menopause

Pałubska

Adamiak‐Godlewska

Winkler

et al. 2017

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Hyperprolactinaemia especially affects women in reproductive age (90/100,000) but also often is diagnosed in menopause age and leads to disturbances in functioning of LH-RH neurons and, as a consequence, to a decrease of FSH and LH, which causes inhibition of oestradiol production. Prolactin is a peptide hormone, phylogenetically one of the oldest, stimulating cells of various organs, which is produced and secreted mainly by lactotrophic acidophilic cells of the anterior lobe of the pituitary. It influences the increase in the mass of the mammary glands, and stimulation and maintenance of lactation after delivery. There are a number of factors apart of pregnancy, delivery, and lactation than can influence secretion of the hormone in other physiological and pathological circumstances, like high-protein diet, stress, REM sleep, or neoplastic tumours, inflammatory diseases, chronic systematic diseases, thyroid hormonal changes, and drug intake. The purpose of this review is to summarise the current knowledge regarding the proper diagnosis and possible influence of hyperprolactinaemia on fertility and menopause symptoms and current treatment methods

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“…A recently published meta-analysis of randomized controlled trials has shown that CBG is more effective in normalizing prolactin levels and is associated with less adverse events when compared to BRC [3]. However, the therapeutic use of high daily doses of CBG has been associated with clinically significant valvular heart disease in patients with Parkinson's disease in a dose-dependent manner [4,5].…”

Section: Introductionmentioning

confidence: 99%

A comparison of cabergoline and bromocriptine on the risk of valvular heart disease in patients with prolactinomas

et al. 2011

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Therapy with dopamine agonists has been associated with valvular heart disease (VHD) in Parkinson's disease, raising concern about the safety of these drugs. In hyperprolactinemic patients, the studies have mainly focused on the cardiac effects of cabergoline (CBG), with little information on bromocriptine (BRC). The aim of the present study was to evaluate the prevalence of VHD in patients with prolactinomas treated with CBG and BRC. The CBG group consisted of 51 patients (37 female; age 42.3 ± 13.5 years) who had been taking CBG for at least 1 year (mean 37.8 ± 21.3 months; cumulative doses 16-1,286.8 mg). The BRC group consisted of 19 patients (14 female; age 41.8 ± 11.5 years) who were on BRC for at least 1 year (mean 54.8 ± 30.2 months; cumulative doses 4,687.5-23,478.8 mg). The controls (CTR) were 59 healthy subjects matched for age, sex, and prevalence of arterial hypertension. Participants were subjected to transthoracic echocardiography and the valvular regurgitation was graduated as absent (grade 0), trace (1), mild (2), moderate (3) or severe (4). Compared to CTR, trace mitral (Mi) regurgitation (49% vs. 27.1%; P = 0.02), trace tricuspid (Tri) regurgitation (45.1% vs. 20.3%; P = 0.0003) and mild Tri regurgitation (7.8% vs. 0%; P = 0.0003) were more prevalent with CBG, while trace Tri regurgitation (73.7% vs. 20.3%; P = 0.0004) were more prevalent with BRC. Mitral tenting area was significantly higher in CBG than in BRC and CTR. None of the valvar abnormalities was associated with symptoms. In conclusion, patients with prolactinomas treated with either CBG or BRC showed higher prevalence of trace and mild Tri or Mi regurgitation, but these findings were not clinically significant.

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Cabergoline versus bromocriptine in the treatment of hyperprolactinemia: a systematic review of randomized controlled trials and meta-analysis

Cited by 99 publications

References 26 publications

Short-Term Pharmacological Suppression of the Hyperprolactinemia of Infertile hCG-Overproducing Female Mice Persistently Restores Their Fertility

Short-Term Pharmacological Suppression of the Hyperprolactinemia of Infertile hCG-Overproducing Female Mice Persistently Restores Their Fertility

Hyperprolactinaemia – a problem in patients from the reproductive period to the menopause

A comparison of cabergoline and bromocriptine on the risk of valvular heart disease in patients with prolactinomas

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