Cabergoline versus bromocriptine in the treatment of hyperprolactinemia: a
systematic review of randomized controlled trials and meta-analysis.
Author(s): dos Santos Nunes V, El Dib R, Boguszewski CL, Nogueira CR.
Affiliation(s): Department of Internal Medicine, Botucatu Medical School, Sao Paulo, State
University/Unesp, Sao Paulo, Brazil. nunesvania2003@yahoo.com.br
Publication date & source: 2011, Pituitary. , 14(3):259-65
Cabergoline and bromocriptine are the most used drugs in the treatment of
hyperprolactinemia, they are able to normalize the prolactin levels, restore
gonadal function and promote tumor reduction in the majority of patients. We
undertake a systematic review and meta-analysis of randomized controlled trials
to compare cabergoline versus bromocriptine in the treatment of patients with
idiopathic hyperprolactinemia and prolactinomas. The data sources were: Embase,
Pubmed, Lilacs and Cochrane Central. The outcome measures were: normalization of
prolactin secretion, restoration of gonadal function, reduction of tumoral
volume, quality of life and adverse drug effects. Were identified 418 references
and after screening by title and abstract, we obtained complete copies of 34
articles potentially eligible for inclusion in the review. From this total, 19
were selected to be included, but fifteen of them were excluded due to the
following reasons: one randomized study compared cabergoline versus placebo and
other randomized study compared different doses of cabergoline; five references
were cases series; four were only controlled studies; three were retrospectives
series and; one was a cohort study. Therefore, four publications were included in
the review and in the final analysis. The meta-analysis of normalization of serum
prolactin levels and menstruation with return of ovulatory cycle showed a
significant difference in favor of cabergoline group (RR 0.67 [CI 95% 0.57,
0.80]) e (RR 0.74 [CI 95% 0.67, 0.83]), respectively. The number of adverse
effects was significantly higher in the bromocriptine number than in cabergoline
group (RR 1.43 [CI 95% 1.03, 1.98]). The meta-analysis showed new evidence
favoring the use of cabergoline in comparison with bromocriptine for the
treatment of prolactinomas and idiopathic hyperprolactinemia.
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