未经批准:三种多巴胺激动剂[溴隐亭,卡麦角林,和喹戈内酯(CV)]已用于高催乳素血症治疗数十年。一些研究回顾了溴隐亭和卡麦角林的疗效和安全性。然而,没有系统评价或荟萃分析讨论CV在高泌乳素血症和泌乳素瘤治疗中的有效性和安全性.
未经授权:五个医疗数据库(PubMed,WebofScience,Embase,Scopus,和Cochrane图书馆)进行搜索,直至2022年5月9日,以确定与CV和高催乳素血症相关的研究。使用森林地块进行了荟萃分析,漏斗图,敏感性分析,元回归,并通过软件R4.0和STATA12对Egger进行测试。
UNASSIGNED:从五个医学数据库中检索了总共1,211项研究,由827例患者组成的33项研究最终纳入分析.在CV治疗下,催乳素浓度正常化和肿瘤减少(>50%)的患者的合并比例分别为69%和20%,分别,95%置信区间为61%-76%和15%-28%,分别。不良反应的合并比例为13%,95%的置信区间为11%-16%。
UNASSIGNED:我们的研究表明,在治疗高催乳素血症方面,CV不亚于卡麦角林和溴隐亭,副作用不显著。因此,该药物可被视为未来治疗高催乳素血症的替代一线或抢救治疗.
UNASSIGNED:https://www。crd.约克。AC.英国/PROSPERO,标识符CRD42022347750。
Three dopamine agonists [bromocriptine, cabergoline, and quinagolide (CV)] have been used for hyperprolactinemia treatment for decades. Several studies have reviewed the efficacy and safety of bromocriptine and cabergoline. However, no systematic review or meta-analysis has discussed the efficacy and safety of CV in hyperprolactinemia and prolactinoma treatment.
Five medical databases (PubMed, Web of Science, Embase, Scopus, and Cochrane Library) were searched up to 9 May 2022 to identify studies related to CV and hyperprolactinemia. A meta-analysis was implemented by using a forest plot, funnel plot, sensitivity analysis, meta-regression, and Egger\'s test via software R 4.0 and STATA 12.
A total of 1,211 studies were retrieved from the five medical databases, and 33 studies consisting of 827 patients were finally included in the analysis. The pooled proportions of patients with prolactin concentration normalization and tumor reduction (>50%) under CV treatment were 69% and 20%, respectively, with 95% confidence intervals of 61%-76% and 15%-28%, respectively. The pooled proportion of adverse effects was 13%, with a 95% confidence interval of 11%-16%.
Our study showed that CV is not less effective than cabergoline and bromocriptine in treating hyperprolactinemia, and the side effects were not significant. Hence, this drug could be considered an alternative first-line or rescue treatment in treating hyperprolactinemia in the future.
https://www.crd.york.ac.uk/PROSPERO, identifier CRD42022347750.