Evidera, part of Thermo Fisher Scientific, Waltham, MA, USA.
Takeda Development Center Americas, Inc., Cambridge, MA, USA.
Pharmaceut Med. 2023 Mar;37(2):153-166. doi: 10.1007/s40290-023-00462-2. Epub 2023 Feb 17.
Screening for drug-induced hyperprolactinaemia, a condition characterised by higher-than-normal levels of serum prolactin induced by drug treatments, requires a comprehensive understanding of the clinical presentations and long-term complications of the condition. Using two databases, Embase and MEDLINE, we summarised the available evidence on the clinical presentations and long-term complications of drug-induced hyperprolactinaemia. Clinical and observational studies reporting on drug treatments known or suspected to induce hyperprolactinaemia were included. Database searches were limited to the English language; no date or geographic restrictions were applied. Fifty studies were identified for inclusion, comprising a variety of study designs and patient populations. Most data were reported in patients treated with antipsychotics, but symptoms were also described among patients receiving other drugs, such as prokinetic drugs and antidepressants. Notably, the diagnosis of drug-induced hyperprolactinaemia varied across studies since a standard definition of elevated prolactin levels was not consistently applied. Frequent clinical presentations of hyperprolactinaemia were menstrual cycle bleeding, breast or lactation disorders, and sexual dysfunctions, described in 80% (40/50), 74% (37/50), and 42% (21/50) of the included studies, respectively. In the few studies reporting such symptoms, the prevalence of vaginal dryness impacted up to 53% of females, and infertility in both sexes ranged from 15 to 31%. Clinicians should be aware of these symptoms related to drug-induced hyperprolactinaemia when treating patients with drugs that can alter prolactin levels. Future research should explore the long-term complications of drug-induced hyperprolactinaemia and apply accepted thresholds of elevated prolactin levels (i.e., 20 ng/mL for males and 25 ng/mL for females) to diagnose hyperprolactinaemia as a drug-induced adverse event.Trial Registration PROSPERO International Prospective Register Of Systematic Reviews (CRD42021245259).
药物性高催乳素血症的筛查，是指由于药物治疗导致血清催乳素水平高于正常值的一种病症，需要全面了解该病症的临床表现和长期并发症。我们使用 Embase 和 MEDLINE 这两个数据库，总结了药物性高催乳素血症的临床表现和长期并发症的现有证据。包括报告已知或疑似引起高催乳素血症的药物治疗的临床和观察性研究。数据库检索仅限于英文，没有时间或地理限制。共确定了 50 项符合纳入标准的研究，包括各种研究设计和患者人群。大多数数据是在接受抗精神病药物治疗的患者中报告的，但在接受其他药物（如促动力药物和抗抑郁药）治疗的患者中也描述了症状。值得注意的是，由于没有一致应用升高的催乳素水平的标准定义，因此，药物性高催乳素血症的诊断在不同的研究中有所不同。高催乳素血症的常见临床表现为月经周期出血、乳房或泌乳障碍和性功能障碍，在纳入的 50 项研究中，分别有 80%（40/50）、74%（37/50）和 42%（21/50）的研究报告了这些症状。在少数报告这些症状的研究中，阴道干燥的患病率高达 53%，两性不孕的患病率分别为 15%至 31%。当治疗可能改变催乳素水平的药物的患者时，临床医生应注意与药物性高催乳素血症相关的这些症状。未来的研究应探讨药物性高催乳素血症的长期并发症，并应用公认的升高催乳素水平阈值（即男性 20ng/mL，女性 25ng/mL）诊断催乳素升高作为药物引起的不良事件。试验注册 PROSPERO 国际前瞻性系统评价注册库（CRD42021245259）。
