Bromocriptine 10mg/5ml oral suspension

BackgroundType 2 diabetes mellitus is a chronic condition driven by insulin resistance and impaired beta-cell function. As beta cells gradually lose function, blood glucose levels rise, leading to clinical diabetes. This condition also elevates the risk of cardiovascular complications. Treatment typically requires multiple medications with different mechanisms of action. Recent developments include bromocriptine, a dopamine agonist approved by the Food and Drug Administration (FDA) for type 2 diabetes, which has been shown to reduce plasma glucose, triglycerides, and free fatty acid levels. To deepen our understanding of type 2 diabetes and refine treatment approaches, a comprehensive analysis of clinical studies and related data is essential.MethodsThis systematic review and meta-analysis investigated the efficacy of bromocriptine in diabetes outcomes by analyzing randomized clinical trials (RCTs) in English up to November 25, 2024. The comprehensive search spanned Scopus, PubMed, and Web of Science, with additional studies identified through supplementary web searches and reference list checks. Inclusion criteria required clinical trials with clear methodologies and defined drug dosages. Data extraction gathered information on study design, outcomes, and intervention specifics, with quality assessment using the JADAD scoring system. Statistical analysis focused on standard mean difference (SMD), while the I2 statistic measured study heterogeneity. A funnel plot analysis was employed to identify publication bias, with all analyses conducted using Comprehensive Meta-Analysis and Stata software.ResultsEighteen RCTs were conducted, revealing that dopamine D2 agonists have a relatively strong impact on reducing Hemoglobin A1C (HbA1c) and fasting blood sugar (FBS). However, with I2 values of 96% for HbA1c and 99% for FBS, the results show high heterogeneity among the studies.ConclusionsBromocriptine presents a promising alternative for individuals with diabetes who cannot tolerate conventional medications. Its unique mechanism of action might offer relief to those who suffer from side effects associated with standard treatments, providing a novel way to manage blood sugar levels.

Abstract licence: CC BY-NC-ND

Bromocriptine has been proposed as a disease-modifying therapy for peripartum cardiomyopathy (PPCM). The long-term outcomes of bromocriptine use remain uncertain. We conducted a systematic review, meta-analysis and trial sequential analysis (TSA) to assess the long-term efficacy and safety of bromocriptine in combination with standard care versus standard care alone in patients with PPCM. We systematically searched PubMed, Embase and Cochrane up until March 2025 for published studies comparing bromocriptine plus standard care with standard care alone in patients with PPCM. The outcomes included changes in left ventricular (LV) ejection fraction, LV end-systolic and end-diastolic dimensions, major adverse cardiovascular events (MACE), all-cause mortality and rehospitalization. We computed mean differences (MDs) for continuous outcomes and odds ratios (ORs) for binary endpoints with 95% confidence intervals (CIs). We used TSA to assess the conclusiveness of the available evidence. A total of 12 studies [2 randomized controlled trials (RCTs) and 10 observational studies] and 1765 patients (age range 29-33.8 years) were included, of whom 474 (26.9%) received bromocriptine with standard care and 1291 (73.1%) received standard care alone. Compared with standard care alone, bromocriptine with standard care was associated with a significant improvement in LV ejection fraction (MD 9.98%; 95% CI: 2.86 to 17.10; P < 0.001), LV end-diastolic diameter (MD -2.51 cm; 95% CI: -4.23 to -0.79; P = 0.004), and LV end-systolic diameter (MD -5.61 cm; 95% CI: -10.03 to -1.18; P = 0.010). The proportion of patients with improved LV function was higher in those who received bromocriptine with standard care than in those who received standard care alone (OR 0.35; 95% CI: 0.16 to 0.75; P = 0.007). There were no significant differences between groups regarding the incidence of MACE, all-cause mortality or heart failure rehospitalization. The TSA showed that LV ejection fraction and diastolic dimension reached the required information size (RIS); however, only LV ejection fraction crossed the monitoring boundary before the full sample size was achieved. In this meta-analysis with TSA, the use of bromocriptine with standard care was associated with improved LV function and remodelling in patients with PPCM compared with standard care alone, with a similar effect on mortality and re-hospitalization. TSA indicated that current evidence is promising, but larger and adequately powered randomized trials are needed to confirm bromocriptine's cardioprotective effects.

Abstract licence: CC BY-NC