Blog
About

54
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Treatment of hyperprolactinemia: a systematic review and meta-analysis

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Hyperprolactinemia is a common endocrine disorder that can be associated with significant morbidity. We conducted a systematic review and meta-analyses of outcomes of hyperprolactinemic patients, including microadenomas and macroadenomas, to provide evidence-based recommendations for practitioners. Through this review, we aimed to compare efficacy and adverse effects of medications, surgery and radiotherapy in the treatment of hyperprolactinemia.

          Methods

          We searched electronic databases, reviewed bibliographies of included articles, and contacted experts in the field. Eligible studies provided longitudinal follow-up of patients with hyperprolactinemia and evaluated outcomes of interest. We collected descriptive, quality and outcome data (tumor growth, visual field defects, infertility, sexual dysfunction, amenorrhea/oligomenorrhea and prolactin levels).

          Results

          After review, 8 randomized and 178 nonrandomized studies (over 3,000 patients) met inclusion criteria. Compared to no treatment, dopamine agonists significantly reduced prolactin level (weighted mean difference, -45; 95% confidence interval, -77 to −11) and the likelihood of persistent hyperprolactinemia (relative risk, 0.90; 95% confidence interval, 0.81 to 0.99). Cabergoline was more effective than bromocriptine in reducing persistent hyperprolactinemia, amenorrhea/oligomenorrhea, and galactorrhea. A large body of noncomparative literature showed dopamine agonists improved other patient-important outcomes. Low-to-moderate quality evidence supports improved outcomes with surgery and radiotherapy compared to no treatment in patients who were resistant to or intolerant of dopamine agonists.

          Conclusion

          Our results provide evidence to support the use of dopamine agonists in reducing prolactin levels and persistent hyperprolactinemia, with cabergoline proving more efficacious than bromocriptine. Radiotherapy and surgery are useful in patients with resistance or intolerance to dopamine agonists.

          Related collections

          Most cited references 191

          • Record: found
          • Abstract: not found
          • Article: not found

          Measuring inconsistency in meta-analyses.

            Bookmark
            • Record: found
            • Abstract: found
            • Article: found

            Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

            David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Meta-analysis in clinical trials

                Bookmark

                Author and article information

                Affiliations
                [1 ]Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
                [2 ]Division of General Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
                [3 ]Division of Preventive Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
                [4 ]Division of Endocrinology, Diabetes, Metabolism, Nutrition, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
                [5 ]Endocrinology, Diabetes and Nutrition Unit, Hospital Universitari de Girona, Dr. Josep Trueta, Avinguda de França, Girona, 17007, Spain
                [6 ]Hospital Nacional de Geriatría y Gerontología, Caja Costarricense de Seguro Social, Avenue 8, San José, Costa Rica
                [7 ]Division of Endocrinology and Metabolism, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
                [8 ]Mayo Clinic Libraries, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
                Contributors
                Journal
                Syst Rev
                Syst Rev
                Systematic Reviews
                BioMed Central
                2046-4053
                2012
                24 July 2012
                : 1
                : 33
                22828169
                3483691
                2046-4053-1-33
                10.1186/2046-4053-1-33
                Copyright ©2012 Wang et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Research

                Public health

                hyperprolactinemia, macroprolactinoma, microprolactinoma, treatment

                Comments

                Comment on this article