Issue: January 2023
Fact checked byRichard Smith

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December 06, 2022
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Bromocriptine appears to drop BP, improve arterial stiffness in teens with type 1 diabetes

Issue: January 2023
Fact checked byRichard Smith
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Bromocriptine, a drug previously used to treat adults with type 2 diabetes and Parkinson’s disease, improved BP and central and peripheral aortic stiffness over 4 weeks in adolescents with type 1 diabetes, researchers reported.

Perspective from Nishant Shah, MD, FACC

“We know that abnormalities in the large vessels around the heart, the aorta and its primary branches begin to develop in early childhood in people with type 1 diabetes,” Michal Schäfer, PhD, researcher and fourth-year medical student at the University of Colorado School of Medicine in Aurora, said in a press release. “We found that bromocriptine has the potential to slow down the development of those abnormalities and decrease the risk for cardiovascular disease in this population.”

Type 1 diabetes diagnosis 2019
Bromocriptine, a drug previously used to treat adults with type 2 diabetes and Parkinson’s disease, improved BP and central and peripheral aortic stiffness over 4 weeks in adolescents with type 1 diabetes.
Source: Adobe Stock

The results of the bromocriptine quick-release type 1 diabetes (BCQR-T1D) study were published in Hypertension.

Bromocriptine’s previous indications

Bromocriptine (Cycloset) is an exogenous sympatholytic D2-dopamine agonist that improves glucose tolerance and insulin sensitivity, according to the study. A quick-release formulation was developed to enhance central nervous system dopaminergic activity and is used to treat adults with type 2 diabetes as well as treat Parkinson’s disease.

Bromocriptine for type 1 diabetes

The BCQR-T1D trial was a placebo-controlled, random-order, double-blind, crossover study that evaluated the effect of bromocriptine 0.8 mg compared with placebo on vascular function in 34 adolescents with type 1 diabetes (mean age, 16 years; mean HbA1c, 8.6%; median type 1 diabetes duration, 6 years).

Participants were assigned to bromocriptine or placebo for 4 weeks in phase 1, followed by a 4-week washout period and then a 4-week phase 2 with the alternate treatment. Participants were uptitrated each week if the treatment was tolerated, according to the study. If uptitration up to 1.6 mg was not tolerated, the patient was withdrawn from the trial.

Upon the completion of each phase of the study, participants underwent CV MRI, pressure hemodynamics and peripheral vascular evaluation.

Compared with placebo, bromocriptine therapy for adolescents with type 1 diabetes:

  • decreased systolic BP (mean difference, 5 mm Hg; 95% CI, 3 to 7; P < .001);
  • decreased diastolic BP (mean difference, 2 mm Hg; 95% CI, 4 to 0; P = .039);
  • reduced ascending aortic pulse wave velocity (mean change, 0.4 m per second; P = .018);
  • increased relative area change (mean change, 2.6%; P = .083); and
  • increased distensibility (mean change, 0.08% mm Hg; P = .017).

Moreover, in the thoracoabdominal aorta, bromocriptine decreased pulse wave velocity (mean change, 0.2 m per second; P = .007) and increased distensibility (mean change, 0.05% per mm Hg; P = .013) compared with placebo.

“A stiff aorta predisposes a patient to other health issues, such as organ dysfunction or atherosclerosis and higher stress or strain on cardiac muscle,” Schäfer said in the release. “We were able to take it a notch further and show, using more sophisticated metrics, that these central large arteries are impaired, and impairment among adolescents and young adults with type 1 diabetes may be decelerated with this drug.”

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