2012 update in the treatment of prolactinomas

Maiter, Dominique; Primeau, Vanessa

doi:10.1016/j.ando.2012.03.024

Cited by 34 publications

(14 citation statements)

References 71 publications

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“…In expert hands, surgery will lead to a sustained reduction in PRL levels in 70-80% of microadenomas, but in only 30-40% of macroadenomas [5]. Moreover, surgery may entail some morbidity, in particular postoperative pituitary hormone deficits.…”

Section: Discussion (1)mentioning

confidence: 98%

“…Moreover, surgery may entail some morbidity, in particular postoperative pituitary hormone deficits. As in every patient with a prolactinoma, pituitary surgery should therefore be proposed to those young women who cannot tolerate dopamine agonists, who are not responsive to maximally tolerated doses of DAs or those who elect to undergo surgery for personal reasons, such as poor compliance to drug therapy [5,6]. Patients with a large macroprolactinoma may sometimes require high doses of cabergoline and may also be good candidates for surgery, even though tumour resection is incomplete.…”

Section: Discussion (1)mentioning

confidence: 99%

“…This disorder has a large female predominance (female-to-male ratio of 8:1) and a median age at diagnosis of 30 years [4,5]. Thus, a prolactinoma is expected to be present in every 1200 women, and more specifically in every 500 women of childbearing age.…”

Section: Introductionmentioning

confidence: 99%

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Prolactinoma and pregnancy: From the wish of conception to lactation

Maiter

2016

Annales d'Endocrinologie

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Section: Discussion (1)mentioning

confidence: 98%

Section: Discussion (1)mentioning

confidence: 99%

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Prolactinoma and pregnancy: From the wish of conception to lactation

Maiter

2016

Annales d'Endocrinologie

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“…Low-dose cabergoline does not seem to cause cardiac fibrosis [29] even as a long-term treatment strategy. Nevertheless, echocardiography is indicated in long-term treatment with higher dosages of cabergoline >2 mg per week [30]. Cabergoline can also be used in women who have indicated a wish to get pregnant; it should not be withdrawn in these patients [30].…”

Section: Recent Advancesmentioning

confidence: 99%

Advances in understanding pituitary tumors

2014

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Pituitary tumors are common in the general population. Since neuroimaging techniques have improved, pituitary tumors are more often diagnosed incidentally. About 16.7% of the general population show changes in the pituitary gland. Predominantly, pituitary tumors are benign pituitary adenomas. Pituitary carcinomas or aggressive pituitary tumors are extremely rare. They might develop from benign adenomas. New genetic and epigenetic abnormalities help us to understand pituitary tumorigenesis and might lead to therapeutical targeting drugs in the future. Macroadenomas (>1 cm) can lead to visual field disturbances, compression of cranial nerves, hypopituitarism, and infiltration of the cavernous sinuses. The functional status of the pituitary tumor is important. About half to one third of all pituitary tumors are non-functioning pituitary adenomas. The other pituitary tumors show a specific pattern of hormone secretion. About 25% to 41% of all pituitary tumors are prolactinomas, acromegaly with production of growth hormone represents 10% to 15% of adenomas, Cushing's disease with production of adrenocorticotropic hormone accounts for 10%, and other hormonal characteristics are less common. Transsphenoidal resection and total adenomectomy are desirable. Radiosurgery has enriched the surgical treatment options. Surgical treatment is the intervention of choice except for prolactinomas, where pharmaceutical treatment is recommended. Pharmaceutical treatment consists of dopamine agonists such as cabergoline and somatostatin analogues that include octreotide and pasireotide; retinoic acid is of theoretical interest while peroxisome proliferator-activated receptor-gamma-ligands are not clinically useful. In acromegaly, pegvisomant is a further treatment option. Temozolomide should be considered in aggressive pituitary tumors. In general, pharmaceutical options developed recently have extended the repertoire of treatment possibilities of pituitary tumors.

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“…Others, with a longer half-life, such as cabergoline, pergolide and quinagolide have recently become available (in the case of pergolide and quinagolide – not in all countries) [32]. Although the new dopamine agonists are considerably more expensive due to their high efficacy and significantly lower percentage of adverse side effects, they are generally preferred to bromocriptine for the therapy of prolactinomas [34–36]. In a recently published systemic review and meta-analysis of randomized controlled trials comparing cabergoline with bromocriptine, cabergoline provided better rates of normalization for PRL levels and menstruation along with less adverse effects, such as nausea and vomiting and better tumor size reduction than bromocriptine [37].…”

Section: Other Pituitary Adenomasmentioning

confidence: 99%

Reviews Pharmacoeconomic aspects of the treatment of pituitary gland tumours

Sowiński¹,

Sawicka²,

Piątek³

et al. 2013

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Nowadays physicians are under economic pressure; therefore therapeutic decisions based on safety, efficacy, and the effectiveness of the medication also require economic analysis. The aim of this review is to discuss data concerning the cost-effectiveness of drug therapy in patients with hormonally active pituitary adenomas, namely growth hormone, adrenocorticotropic hormone, thyroid-stimulating hormone-secreting pituitary adenomas, prolactinoma and pituitary incidentaloma.In acromegalic patients using lanreotide is cheaper for health care payers and more convenient for physicians and patients because of the opportunity for self/partner injections, lower clogging risk and possibility of longer intervals between injections, while the efficacy is comparable with octreotide. Patients with prolactinomas should be treated with novel dopamine agonists, such as cabergoline or quinagolide, however, bromocriptine still remains a cheaper and almost as effective alternative.There are no easy methods or algorithms, but in general, extracting the maximum value from the investment in treatment is essential.

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2012 update in the treatment of prolactinomas

Cited by 34 publications

References 71 publications

Prolactinoma and pregnancy: From the wish of conception to lactation

Prolactinoma and pregnancy: From the wish of conception to lactation

Advances in understanding pituitary tumors

Reviews Pharmacoeconomic aspects of the treatment of pituitary gland tumours

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