Bromocriptine in Rheumatic Diseases: A Review

Hyperprolactinemia is frequent in rheumatic diseases. Bromocriptine (BRC) is an antagonist of pro- lactin and was studied in a few rheumatic diseases with controversial results. The aim of the present study was to review articles on BRC in rheumatic diseases. Articles on lupus, rheumatoid arthritis, pso- riatic arthritis (PsA), and reactive arthritis were found. Fourteen articles were found. In lupus, 5 articles evaluated BRC in a 2.5-7.5 mg/day dosage. The follow-up varied from 6 to 14 months. They showed improvement in lupus disease activity (Lupus Disease Activity Index or Lupus activity measure scores) in 4/5; a trend was verified in another article, 1/5, and one study evaluated improvement in the mood of the systemic lupus erythematosus patients. In RA, there are 4 articles with 119 patients. The BRC dosage ranged from 5 mg/day to 10 mg TID. About 2/4 of the articles showed improvements [morn- ing stiffness and Health Assessment Questionnaire (HAQ)], and 2/4 did not show any difference. Regarding PsA and reactive arthritis, 5 articles with 43 patients were found. The BRC dose varied from 2.5 to 30 mg/day. All studies showed improvements of the studied diseases. Side effects were mild and infrequent. In conclusion, BRC seems to be efficacious in a few rheumatic diseases (lupus, PsA, RA, and Reiter's), with mild side effects. Future studies with a larger number of participants and in other rheumatic diseases are needed.