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Meta-Analysis
. 2023 Jan 24:14:1027905.
doi: 10.3389/fendo.2023.1027905. eCollection 2023.

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

Yanyang Zeng  1 , Qingliang Huang  2 , Yunzhi Zou  3 , Jiacong Tan  1 , Wu Zhou  1 , Meihua Li  1
Affiliations
Meta-Analysis

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

Yanyang Zeng et al. Front Endocrinol (Lausanne). .

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.

PubMed Disclaimer

Conflict of interest statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Figures

Figure 1
Figure 1
Flow diagram of the studies included in this systematic review and meta-analysis.
Figure 2
Figure 2
The efficacy of quinagolide (CV) in hyperprolactinemia and prolactinoma treatment. (A) The bulk efficacy of CV treatment in hyperprolactinemia; (B) The pooled risk ratios (RRs) of efficacy between CV vs. cabergoline (CAB) and CV vs. bromocriptine (BRC); (C) The efficacy of CV treatment in prolactinomas.
Figure 3
Figure 3
Sensitivity analysis. (A) Single-armed studies related to hyperprolactinemia treatment; (B) Single-armed studies related to prolactinoma treatment; (C) Double-armed studies.
Figure 4
Figure 4
Funnel plot. (A) Double-armed studies; (B) Single-armed studies related to prolactinoma treatment; (C) Single-armed studies related to hyperprolactinemia treatment.
Figure 5
Figure 5
The safety of quinagolide treatment. (A) The pooled proportion of constipation, depression, dizziness, drowsiness, drug discontinuance, fatigue; (B) The pooled proportion of headache, muscle pain, nasal congestion, nasal stuffiness, nausea; (C) The pooled proportion of palpitation, tiredness, vomiting, weight loss; (D) The pooled proportion of other digestive disorders, other mental disorders, postural disorders, sleep disorders.
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