The efficacy and safety of quinagolide in hyperprolactinemia treatment: A systematic review and meta-analysis

Front Endocrinol (Lausanne). 2023 Jan 24:14:1027905. doi: 10.3389/fendo.2023.1027905. eCollection 2023.

Abstract

Purpose: 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.

Methods: 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.

Results: 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%.

Conclusion: 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.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO, identifier CRD42022347750.

Keywords: bromocriptine; cabergoline; dopamine agonist; efficacy; hyperprolactinemia; meta-analysis; prolactinomas; quinagolide.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aminoquinolines* / adverse effects
  • Aminoquinolines* / therapeutic use
  • Bromocriptine
  • Cabergoline / therapeutic use
  • Drug-Related Side Effects and Adverse Reactions*
  • Humans
  • Hyperprolactinemia* / chemically induced
  • Hyperprolactinemia* / drug therapy
  • Pituitary Neoplasms* / chemically induced
  • Pituitary Neoplasms* / drug therapy

Substances

  • Bromocriptine
  • Cabergoline
  • quinagolide
  • Aminoquinolines

Grants and funding

This research was funded by the National Natural Science Foundation of China (NSFC) (No. 81860225), the key research and development plan of Jiangxi Province (No. 20203BBG73060), natural science foundation of Jiangxi Province (No. 20212BAB206029), science and technology project of Jiangxi Provincial Health Care Commission (No.20195116), and young talents research and cultivation foundation of the First Affiliated Hospital of Nanchang University (No. YFYPY202038).