Cabergoline - Dopamine Receptor Agonist

Kondeti Venkata Surya Siva Kumar; Saripella Latha Sree; Saripella Jaya Sree

doi:10.55940/medphar202346

Authors

Kondeti Venkata Surya Siva Kumar Chebrolu Hanumaiah Institute of Pharmaceutical Sciences
Saripella Latha Sree
Saripella Jaya Sree

DOI:

https://doi.org/10.55940/medphar202346

Abstract

Background: Cabergoline is a potent dopamine receptor agonist used primarily for the treatment of disorders related to dopamine dysregulation. It acts by stimulating dopamine receptors in various regions of the brain and has been approved for the management of hyperprolactinemia, Parkinson's disease, and restless legs syndrome. Its unique pharmacological profile and tolerability make it a valuable therapeutic option in the field of neurology and endocrinology.

Aim: The aim of this study was to investigate the efficacy and safety of cabergoline as a dopamine receptor agonist in the treatment of hyperprolactinemia, Parkinson's disease, and restless legs syndrome. The study also aimed to evaluate the impact of cabergoline on disease-specific symptoms and quality of life in patients with these conditions.

Materials and Methods: A systematic literature review was conducted, encompassing peer-reviewed studies, clinical trials, and meta-analyses from reputable databases. Key search terms included "Cabergoline," "dopamine receptor agonist," "hyperprolactinemia," "Parkinson's disease," and "restless legs syndrome." Studies involving adult patients and reporting relevant outcomes, including symptom improvement and adverse events, were considered for analysis.

Results: The analysis revealed that cabergoline effectively reduced prolactin levels in patients with hyperprolactinemia, leading to improvements in associated symptoms such as menstrual irregularities and galactorrhea. In Parkinson's disease, cabergoline demonstrated promising results in ameliorating motor symptoms, including rigidity, bradykinesia, and tremors. Additionally, studies investigating its role in restless legs syndrome showed a reduction in sensory and motor symptoms, leading to enhanced sleep quality. The drug's side effect profile was generally well-tolerated, with mild adverse events reported.

Conclusion: Cabergoline, as a dopamine receptor agonist, emerges as a valuable therapeutic option for hyperprolactinemia, Parkinson's disease, and restless legs syndrome. It effectively addresses specific symptoms associated with these conditions and shows potential for improving patients' quality of life. The drug's favorable tolerability further supports its use in clinical practice. However, careful monitoring and further research are necessary to fully elucidate its long-term safety and effectiveness. Cabergoline's role in the treatment landscape of dopamine-related disorders holds promise for future advancements in neurology and endocrinology.

References

Elks J, editor. The dictionary of drugs: chemical data: chemical data, structures and bibliographies. Springer; 2014 Nov 14. pp. 204–.

Fischer J, Ganellin CR (). Analog-based. John Wiley & Sons; 2006. p. 533. ISBN 9783527607495.

Brar SS, Khan SS, Sandhu GK, Jorgensen MB, Parikh N, Hsu JW, Shen AY. Incidence, mortality, and racial differences in peripartum cardiomyopathy. The American journal of cardiology. 2007 Jul 15;100(2):302-4. DOI:10.1016/j.amjcard.2007.02.092

Sliwa K, Bauersachs J, Arany Z, Spracklen TF, Hilfiker-Kleiner D. Peripartum cardiomyopathy: from genetics to management. European Heart Journal. 2021;42(32):3094-102.

Honigberg MC, Givertz MM. Peripartum cardiomyopathy. Bmj. 2019 Jan 30;364. DOI: 10.1136/bmj.k5287

Pearson GD, Veille JC, Rahimtoola S, Hsia J, Oakley CM, Hosenpud JD, Ansari A, Baughman KL. Peripartum cardiomyopathy: national heart, lung, and blood institute and office of rare diseases (National Institutes of Health) workshop recommendations and review. Jama. 2000 ;283(9):1183-8. DOI: 10.1001/jama.283.9.1183

Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJV, Ponikowski P, Poole-Wilson PA, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM): The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaborati. Eur J Heart Fail . 2008;10(10):933–89. DOI: 10.1016/j.ejheart.2008.08.005

Sliwa K, Blauwet L, Tibazarwa K, Libhaber E, Smedema J-P, Becker A, et al. Evaluation of bromocriptine in the treatment of acute severe Peripartum cardiomyopathy: A proof-of-concept pilot study. Circulation. 2010;121(13):1465–73. DOI: 10.1161/circulationaha.109.901496

Hilfiker-Kleiner D, Haghikia A, Berliner D, Vogel-Claussen J, Schwab J, Franke A, et al. Bromocriptine for the treatment of peripartum cardiomyopathy: a multicentre randomized study. Eur Heart J. 2017;38(35):2671–9. DOI: 10.1093/eurheartj/ehx355

Al-Hussaniy HA, Al-kuraishy AA, Jalil HJ. Evaluation of the efficacy of adrenergic neurons inhibition through various surgical and therapeutic regimens on controlling blood pressure and circadian rhythm in patients with uncontrolled hypertension. Journal of Clinical Trials and Experimental Investigations. 2022 ;1(3):106-13.

Fariello RG. Pharmacodynamic and pharmacokinetic features of cabergoline: rationale for use in Parkinson’s disease. Drugs. 1998;55:10-6. DOI: 10.2165%2F00003495-199855001-00002

Hoeppner LH, Wang Y, Sharma A, Javeed N, Van Keulen VP, Wang E, Yang P, Roden AC, Peikert T, Molina JR, Mukhopadhyay D. Dopamine D2 receptor agonists inhibit lung cancer progression by reducing angiogenesis and tumor infiltrating myeloid derived suppressor cells. Molecular oncology. 2015;9(1):270-81. DOI: 10.1016%2Fj.molonc.2014.08.008

Millan MJ, Maiofiss L, Cussac D, Audinot V, Boutin JA, Newman-Tancredi A. Differential actions of antiparkinson agents at multiple classes of monoaminergic receptor. I. A multivariate analysis of the binding profiles of 14 drugs at 21 native and cloned human receptor subtypes. Journal of Pharmacology and Experimental Therapeutics. 2002;303(2):791-804. DOI: 10.1124/jpet.102.039867

Sharif NA, McLaughlin MA, Kelly CR, Katoli P, Drace C, Husain S, et al. Cabergoline: Pharmacology, ocular hypotensive studies in multiple species, and aqueous humor dynamic modulation in the Cynomolgus monkey eyes. Exp Eye Res . 2009;88(3):386–97. DOI: 10.1016/j.exer.2008.10.003Newman-Tancredi A, Cussac D, Audinot V, Nicolas J-P, De Ceuninck F, Boutin J-A, et al. Differential actions of antiparkinson agents at multiple classes of monoaminergic receptor. II. Agonist and antagonist properties at subtypes of dopamine D(2)-like receptor and alpha(1)/alpha(2)-adrenoceptor. J Pharmacol Exp Ther. 2002;303(2):805–14. DOI: 10.1124/jpet.102.039875

Schade R, Andersohn F, Suissa S, Haverkamp W, Garbe E. Dopamine agonists and the risk of cardiac-valve regurgitation. N Engl J Med. 2007;356(1):29–38. Available from: 10.1056/NEJMoa062222

Zanettini R, Antonini A, Gatto G, Gentile R, Tesei S, Pezzoli G. Valvular heart disease and the use of dopamine agonists for Parkinson’s disease. N Engl J Med. 2007;356(1):39–46. DOI: 10.1056/NEJMoa054830

Al-Hussaniy HA. The Effect of MicroRNA-409-3p for Treatment and Response to Tumor Proliferation of Lung Cancer Cell Lines (In Vitro). Asian Pacific Journal of Cancer Prevention: APJCP. 2022 Sep;23(9):3151.

25. Colao A, Abs R, Bárcena DG, Chanson P, Paulus W, Kleinberg DL. Pregnancy outcomes following cabergoline treatment: extended results from a 12-year observational study. Clin Endocrinol (Oxf). 2008;68(1):66–71 DOI: 10.1111/j.1365-2265.2007.03000.x

UK electronic Medicines Compendium Dostinex Tablets Last Updated on eMC December 23. Farid NF, Abdelwahab NS. Development and validation of different chromatographic methods for analysis of cabergoline in the presence of its degradation products: studying degradation profile. Chromatographia. 2019;82(10):1555-69.

Budayr A, Tan TC, Lo JC, Zaroff JG, Tabada GH, Yang J, et al. Cardiac valvular abnormalities associated with use and cumulative exposure of cabergoline for hyperprolactinemia: the CATCH study. BMC Endocr Disord . 2020;20(1):25. DOI: 10.1186/s12902-020-0507-8

Lin S, Zhang A, Zhang X, Wu ZB. Treatment of pituitary and other tumours with cabergoline: New mechanisms and potential broader applications. Neuroendocrinology. 2020;110(6):477–88. DOI: 10.1159/000504000

Kizilgul M, Duger H, Nasiroglu NI, Sencar E, Hepsen S, Akhanli P, et al. Efficacy of cabergoline add-on therapy in patients with acromegaly resistance to somatostatin analogs treatment and the review of literature. Arch Endocrinol Metab. 2022; DOI: 10.20945/2359-3997000000481