[Efficacy of oral bromocriptine in protecting the postpartum systemic lupus erythematosus patients from disease relapse].
OBJECTIVE
To explore the efficacy of oral bromocriptine in protecting the postpartum patients with systemic lupus erythematosus (SLE) from disease relapse.


METHODS
The research strategy was a randomized controlled trial. 68 consecutive pregnancy patients with SLE from July 1995 to June 2002 followed up in the teaching hospital were included in the study. The patients were randomly divided into the treatment group and the control group according to their expected date of confinement. The patients in the treatment group had bromocriptine (2.5 mg bid) for 14 days started within 12 hours of postpartum and didn't nurse their infants. The patients in the controlled group didn't have any treatment of influence on prolactin or other sexual hormones. 21 patients nursed and 13 didn't nurse their infants in the controlled group. All patients were followed up for 12 months.


RESULTS
The serum prolactin and estradiol levels in treatment group were lower than in nursing controlled group and in non nursing controlled groups, at second week and second month after delivery. The relapse rate in the treatment group was lower than in nursing controlled group and in non nursing controlled groups. The result of Log-rank test was chi(2) = 8.90, P = 0.007 5 comparing three group data of following up with SLEDAI increase 3 as endpoint. The number needed treatment was 3.1, 95% CI (1.9-8.5). Accumulative doses of prednisone within the 12 months were (3.90 +/- 1.82) g in the treatment group and (8.92 +/- 3.36) g in the controlled group, P < 0.001, and cyclophosphamide were (1.41 +/- 0.83) g in the treatment group and (4.27 +/- 2.38) g in the controlled group, P < 0.001.


CONCLUSIONS
Oral bromocriptine for 2 weeks in postpartum patients with SLE may relieve the disease from hyperprolactinemia and hyperestrogenemia, and may be beneficial in protecting the patients from disease relapse and in reducing the usage of steroid and immunosuppressant.
D000284:Administration, Oral; D000328:Adult; D001971:Bromocriptine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000517:prevention & control*; D011247:Pregnancy; D011388:Prolactin / Q000097:blood; D011644:Puerperal Disorders / Q000517:prevention & control*
D001971:Bromocriptine; D004958:Estradiol; D011388:Prolactin