Objective: To assess the efficacy and safety of aripiprazole, bromocriptine, and cabergoline in the treatment of hyperprolactinemia (HPRL) using network meta-analysis.
Method: We searched PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, VIP, and China Biology Medicine disc (CBMdisc) for randomized controlled trials (RCTs). The quality of the included studies was assessed using the Cochrane risk-of-bias tool, and data were analyzed using RevMan 5.4, R 4.3.3, and Stata 17.
Results: 44 RCTs involving a total of 3886 patients were finally included. The results showed that at 12 week of treatment, cabergoline plus conventional therapy had optimal efficacy in reducing prolactin (PRL) levels. Cabergoline plus conventional therapy was most effective in reducing PRL levels in patients with non-drug-induced HPRL. Aripiprazole plus conventional therapy had optimal efficacy in reducing PRL levels in patients with antipsychotics-induced or antidepressant-induced HPRL. Bromocriptine was the most efficacious intervention in improving estrogen (E2) levels.
Conclusion: Three dopamine receptor agonists (DAs) have different advantages in improving serum PRL and E2 levels in HPRL patients.
Prospero id: CRD42024510695.
Keywords: Aripiprazole; bromocriptine; cabergoline; hyperprolactinemia; network meta-analysis.