The role of bromocriptine in the treatment of patients with active rheumatoid arthritis

Salesi, Mansour; Sadeghihaddadzavareh, Somayeh; Nasri, Parto; Namdarigharaghani, Nasrin; Farajzadegan, Ziba; Hajalikhani, Mehri

doi:10.1111/1756-185x.12015

Cited by 14 publications

(6 citation statements)

References 6 publications

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“…Similarly, bromocriptine treatment could improve joint and skin symptoms in patients with PsA [51]. Another study did not find a beneficial effect of bromocriptine in the treatment of RA [52]. Thus, selective targeting of synovial PRLR signaling might represent a novel therapeutic target in RA and PsA.…”

Section: Discussionmentioning

confidence: 99%

Rheumatoid arthritis and psoriatic arthritis synovial fluids stimulate prolactin production by macrophages

Tang

García

Fernández

et al. 2017

Journal of Leukocyte Biology

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Prolactin (PRL) is a neuroendocrine hormone that can promote inflammation. We examined the synovial tissue and fluid levels of PRL in patients with inflammatory arthritis, PRL expression in differentiated Mϕs from patients with arthritis and from healthy donors, and the effects of different stimuli on PRL production by Mϕs. PRL levels were measured in paired synovial fluid (SF) and peripheral blood of patients with rheumatoid arthritis (RA, = 19), psoriatic arthritis (PsA, = 11), and gout ( = 11). Synovial-tissue PRL mRNA expression was measured by quantitative PCR in patients with RA ( = 25), PsA ( = 11), and gout ( = 12) and in Mϕs differentiated in SF of patients with RA, PsA, other subtypes of spondyloarthritis (SpA), and gout. Synovial-tissue PRL mRNA expression correlated significantly with clinical disease parameters in patients with RA and PsA, including erythrocyte sedimentation rate (ESR, = 0.424; = 0.049) and disease activity score evaluated in 28 joints (DAS28, = 0.729; = 0.017). Synovial-tissue PRL expression was similar in RA, PsA, and gout. PRL mRNA expression was detected in monocyte-derived Mϕs from patients with RA and was significantly higher ( ≤ 0.01) in Mϕs differentiated in pooled SF from patients with RA and PsA compared with SpA or gout. PRL production by Mϕ differentiation in the SF from patients with RA was not further regulated by stimulation with CD40L, IgG, LPS, or TNF. PRL is produced locally in the synovium of patients with inflammatory arthritis. The production of PRL by Mϕs was increased by unknown components of RA and PsA SF, where it could contribute to disease progression.

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Section: Discussionmentioning

confidence: 99%

Rheumatoid arthritis and psoriatic arthritis synovial fluids stimulate prolactin production by macrophages

Tang

García

Fernández

et al. 2017

Journal of Leukocyte Biology

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“…Some studies, on the other hand, have claimed a cartilage protective effect. Case reports of experimental treatment with dopamine agonists such as Bromocriptine have also been inconsistent, in some showing improvement in the in vitro immune function and HAQ disability scores, whereas in others exhibiting nonsignificant improvement as compared with placebo [ 17 , 18 ]. Further studies are definitely warranted to outline the exact role of prolactin in association with autoimmunity but until then its influence still remains elusive.…”

Section: Case Discussionmentioning

confidence: 99%

Rheumatoid Arthritis, Kartagener’s Syndrome, and Hyperprolactinemia: Who Started It?

Halabi

Mulla

2016

Case Reports in Rheumatology

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We report a case of an 18-year-old girl who presented to our hospital with history of recurrent respiratory infections, amenorrhea, and symmetric polyarthritis. She was diagnosed with rheumatoid arthritis (RA), Kartagener's syndrome (KS), and hyperprolactinemia. There have been very few case reports in the literature of RA occurring in the setting of KS, theoretically proposed to be due to chronic stimulation of the immune system by recurrent infections. Furthermore, hyperprolactinemia has been hypothesized to mirror RA disease activity and case reports of treatment with dopamine agonists have led to the speculation of whether or not they represent a new line of experimental treatment in the future. Our patient was found to have both KS and hyperprolactinemia together in the setting of RA, and based on our literature search, this is the first reported case of such a combination. This strikes a very intriguing question: are these three conditions interlinked by a yet to be defined association? And treatment of which condition leads to the resolution of the other?

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“…However, others have demonstrated that severe disease is associated with longer period of breast-feeding and larger number of breastfed children [149]. A randomized placebo controlled study of bromocriptine offered in 88 patients with active RA on background treatment with methotrexate did not have any significant impact on disease activity score at three months [150].…”

Section: Rheumatoid Arthritismentioning

confidence: 93%

Hyperprolactinaemia

Samperi

Lithgow

Karavitaki

2019

JCM

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Hyperprolactinaemia is one of the most common problems in clinical endocrinology. It relates with various aetiologies (physiological, pharmacological, pathological), the clarification of which requires careful history taking and clinical assessment. Analytical issues (presence of macroprolactin or of the hook effect) need to be taken into account when interpreting the prolactin values. Medications and sellar/parasellar masses (prolactin secreting or acting through "stalk effect") are the most common causes of pathological hyperprolactinaemia. Hypogonadism and galactorrhoea are well-recognized manifestations of prolactin excess, although its implications on bone health, metabolism and immune system are also expanding. Treatment mainly aims at restoration and maintenance of normal gonadal function/fertility, and prevention of osteoporosis; further specific management strategies depend on the underlying cause. In this review, we provide an update on the diagnostic and management approaches for the patient with hyperprolactinaemia and on the current data looking at the impact of high prolactin on metabolism, cardiovascular and immune systems.

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The role of bromocriptine in the treatment of patients with active rheumatoid arthritis

Abstract: In patients with active RA receiving stable doses of MTX, bromocriptine showed non-significant improvement in efficiency outcomes compared to placebo.

Cited by 14 publications

References 6 publications

Rheumatoid arthritis and psoriatic arthritis synovial fluids stimulate prolactin production by macrophages

Rheumatoid arthritis and psoriatic arthritis synovial fluids stimulate prolactin production by macrophages

Rheumatoid Arthritis, Kartagener’s Syndrome, and Hyperprolactinemia: Who Started It?

Hyperprolactinaemia

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