McMurray R W, Weidensaul D, Allen S H, Walker S E
Department of Internal Medicine, University of Missouri-Columbia 65212, USA.
J Rheumatol. 1995 Nov;22(11):2084-91.
To investigate the efficacy of bromocriptine in suppressing active systemic lupus erythematosus (SLE) in a therapeutic trial.
We conducted an open label investigation of bromocriptine treatment in 7 patients with active non-life threatening SLE. Patients received bromocriptine daily during the treatment phase of 6 to 9 months and were followed for 5 months after bromocriptine was discontinued. Disease activity was assessed by determination of the SLE activity Measure (SLAM) and the Toronto SLE Disease Activity Index (SLEDAI). Serum prolactin concentrations and a battery of serologic and urine tests were obtained at baseline and at monthly intervals during and after bromocriptine treatment.
Serum prolactin concentration was suppressed from (mean +/- SEM) 11.2 ng/ml +/- 1.9 to 3.1 ng/ml +/- 1.7 after 6 months of bromocriptine treatment. The mean pretreatment SLAM score was 11.3 +/- 0.9;6 months of bromocriptine treatment significantly decreased the mean SLAM score to 6.0 +/- 1.6 (p = 0.03 compared to pretreatment measure). The mean SLEDAI score decreased from 16.0 +/- 2.0 to 5.9 +/- 0.8 (p = 0.02) during the same period. Bromocriptine treatment was associated with transient suppression of anti-dsDNA, and serum cholesterol was reduced significantly through the treatment period. After bromocriptine was discontinued, all patients had increased disease activity associated with rising serum prolactin concentrations.
These findings justify controlled trials to study the efficacy of bromocriptine in treating patients with active SLE.
在一项治疗试验中研究溴隐亭抑制活动性系统性红斑狼疮（SLE）的疗效。
我们对7例非危及生命的活动性SLE患者进行了溴隐亭治疗的开放标签研究。患者在6至9个月的治疗阶段每日服用溴隐亭，并在停用溴隐亭后随访5个月。通过测定SLE活动度量表（SLAM）和多伦多SLE疾病活动指数（SLEDAI）评估疾病活动度。在基线时以及溴隐亭治疗期间和治疗后每月采集血清催乳素浓度以及一系列血清学和尿液检测结果。
溴隐亭治疗6个月后，血清催乳素浓度从（均值±标准误）11.2 ng/ml±1.9降至3.1 ng/ml±1.7。治疗前SLAM评分均值为11.3±0.9；溴隐亭治疗6个月后，平均SLAM评分显著降至6.0±1.6（与治疗前测量值相比，p = 0.03）。同期SLEDAI评分均值从16.0±2.0降至5.9±0.8（p = 0.02）。溴隐亭治疗与抗双链DNA的短暂抑制相关，且在整个治疗期间血清胆固醇显著降低。停用溴隐亭后，所有患者疾病活动度增加，血清催乳素浓度升高。
这些发现证明有必要进行对照试验以研究溴隐亭治疗活动性SLE患者的疗效。
