Efficacy and Safety of Bromocriptine-QR as an Adjunctive Therapy on Glycemic Control in Subjects with Uncontrolled Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis

Theo Audi Yanto; Charista Lydia Budiputri; Michelle Patricia Muljono; Shally Chandra

doi:10.15605/jafes.039.01.19

Authors

Theo Audi Yanto Universitas Pelita Harapan https://orcid.org/0000-0002-6939-7144
Charista Lydia Budiputri Universitas Pelita Harapan https://orcid.org/0000-0002-2129-842X
Michelle Patricia Muljono Universitas Pelita Harapan https://orcid.org/0000-0002-7764-4686
Shally Chandra Universitas Pelita Harapan https://orcid.org/0000-0001-6160-3241

DOI:

https://doi.org/10.15605/jafes.039.01.19

Keywords:

bromocriptine-QR, type 2 diabetes mellitus, HbA1C, side effects, glycaemic control, dopaminergic

Abstract

Introduction. There has been an increasing awareness of the effects of combining bromocriptine-QR with other medications for diabetes mellitus type 2. This study aimed to assess the efficacy and safety of bromocriptine-QR as an adjunctive therapy for patients with uncontrolled type 2 diabetes mellitus.

Methodology. This systematic review is registered at the International Prospective Register of Systematic Reviews (CRD42022360326). Literature search was done via MEDLINE, NCBI, Google Scholar, Science Direct, Europe PMC and Cochrane Library databases. We included randomized controlled trials with participants 18 years old and above with uncontrolled type 2 diabetes mellitus. The primary outcome of interest is the efficacy and safety of bromocriptine-QR as an adjunctive therapy for glycemic control. Case reports, case series, reviews and animal studies were excluded. The risk of bias was reviewed using the Cochrane Risk of Bias tool. Meta-analysis was performed using Review Manager 5.4 and presented as a weighted mean difference and 95% confidence interval for changes from the baseline level.

Results. Nine studies were included in the systematic review with a total of 2709 participants. The baseline HbA1c in the bromocriptine-QR group was 7.42% and 7.51% in the control group. The bromocriptine-QR group was favoured, outperforming the control group in terms of reducing hemoglobin A1c(HbA1c), with a statistically significant difference (weighted mean difference -0.6%; 95% CI [-0.83,-0.36]; p<0.00001). The most common side effects were nausea (33.75% vs 6.92%), fatigue (13.11% vs 5.94%), and headache (11.17% vs 6.87%).

Conclusion. Administration of bromocriptine-QR at a dose range of 1.6 to 4.8 mg/day as an adjunctive therapy reduced HbA1c and FBG in patients with uncontrolled type 2 diabetes mellitus (T2DM). However, there were also statistically greater odds of the occurrence of adverse events such as nausea, vomiting, and headache compared to controls.

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Author Biographies

Theo Audi Yanto, Universitas Pelita Harapan

Department of Internal Medicine, Faculty of Medicine, Universitas Pelita Harapan, Karawaci, Tangerang, Banten, Indonesia

Charista Lydia Budiputri, Universitas Pelita Harapan

Department of Internal Medicine, Faculty of Medicine, Universitas Pelita Harapan, Karawaci, Tangerang, Banten, Indonesia

Michelle Patricia Muljono, Universitas Pelita Harapan

Department of Internal Medicine, Faculty of Medicine, Universitas Pelita Harapan, Karawaci, Tangerang, Banten, Indonesia

Shally Chandra, Universitas Pelita Harapan

Department of Internal Medicine, Faculty of Medicine, Universitas Pelita Harapan, Karawaci, Tangerang, Banten, Indonesia

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