Bromocriptine therapy in acromegaly. A long-term review of 35 cases

Sachdev, Y; Gopal, K.; Garg, V. K.

doi:10.1136/pgmj.57.666.210

Cited by 13 publications

(10 citation statements)

References 34 publications

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“…The doses of bromocriptine used to treat chronic hepatic encephalopathy are modest compared with those used in Parkinsonism (Calne et al, 1978;Parkes, 1979), acromegaly (Sachdev et al, 1981) and in the treatment of prolactinomas (Archer et al, 1982). Despite the fact that many patients have been exposed to much higher doses of bromocriptine for as long or longer than the patients reported here, no previous reports of bromocriptine-associated ototoxicity exist.…”

Section: Discussioncontrasting

confidence: 39%

Bromocriptine-associated ototoxicity

Lanthier¹,

Morgan

Ballantyne

1984

J. Laryngol. Otol.

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Section: Discussioncontrasting

confidence: 39%

Bromocriptine-associated ototoxicity

Lanthier¹,

Morgan

Ballantyne

1984

J. Laryngol. Otol.

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“…However, subsequent studies reported relatively low rates of GH response with only 20-40% of patients achieving GH levels <5 μg/l, and only 10-20% achieving normalization of IGF-1 levels, despite subjective clinical improvement in 50% of patients [65,70,71].…”

Section: Secondary Treatmentmentioning

confidence: 91%

“…Some concerns persist that the rise in GH which occurs with pegvisomant therapy may have some deleterious effects on tumor growth [80], however, the rapidly growing body of clinical experience is reassuring; Schreiber et al has recently published the clinical outcomes for 229 patients treated for a mean of 51.8 weeks, with tumor growth verified in only 3.1% of patients [81]. Safety concerns aside, the cost of pegvisomant remains the primary barrier to its widespread use, which was the same issue with bromocriptine 25 years ago [70]. Currently, pegvisomant offers a highly effective, last-line medical treatment for patients who have failed lower-cost options.…”

Section: Clinical Trialsmentioning

confidence: 93%

Management of acromegaly: Is there a role for primary medical therapy?

Bush

Vance

2007

Rev Endocr Metab Disord

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Acromegaly is a chronic, debilitating disease caused by chronic growth hormone (GH) hypersecretion which results in chronic medical comorbidities, poor quality of life and high mortality rates. Successful treatment can improve clinical signs and symptoms and normalize mortality rates. Over 95% of acromegaly is caused by a somatotroph adenoma of the pituitary, and the first-line treatment is generally transsphenoidal surgery, which can be curative in 50-60% of patients. Nonetheless, high rates of persistent acromegaly following surgery and the limited efficacy of radiation therapy necessitate chronic medical treatment for many patients. Somatostatin analogues have become the preferred first-line medical therapy for many practitioners, as they achieve better biochemical and direct tumor control than the dopamine agonists, and long-acting preparations make once monthly administration possible. Cabergoline, a dopamine agonist, offers a lower-cost option and may be effective in patients with a pituitary tumor that co-secretes GH and prolactin. Pegvisomant is a GH receptor antagonist that produces exceptional biochemical response rates but lacks any direct effects on the tumor, which may limit its effectiveness as life-long monotherapy. Combinations of these three drug classes have not been rigorously studied, and preliminary trials do not suggest improved clinical outcomes. While medical treatment options for acromegaly have significantly improved over the last 30 years, limitations remain, and a multi-specialty team approach is necessary for the effective long-term management of patients with acromegaly.

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“…34,35 These agents are orally active and less expensive compared with other medical therapies. The efficacy of bromocriptine in controlling acromegaly, however, is disappointing.…”

Section: Efficacy Of Dopamine Agonistsmentioning

confidence: 99%

Role of Somatostatin Receptor Subtypes in Acromegaly

Hoek¹,

Lamberts²,

Hofland³

2005

The Endocrinologist

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The clinical introduction of the long acting somatostatin (SS) analogs in the early 1980s added a new dimension to the treatment of acromegaly. Octreotide and lanreotide form a safe and effective medical therapeutic modality for acromegaly, mimicking the action of the native hypothalamic peptide SS as the principal negative regulator of GH secretion by pituitary somatotrophs. This review discusses the current knowledge on clinical efficacy of the current clinically available SS analogs as a widely accepted treatment option for acromegaly. Moreover, based on the efforts by several research groups that provided essential insights with respect to SS receptor (patho) physiology, we will also focus upon newly developed SS analogs that can become of additional value to increase the number of acromegalic patients that can be controlled during long-term medical treatment.

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Bromocriptine therapy in acromegaly. A long-term review of 35 cases

Abstract: SummaryBromocriptine Parlodel, Sandoz)

Cited by 13 publications

References 34 publications

Bromocriptine-associated ototoxicity

Bromocriptine-associated ototoxicity

Management of acromegaly: Is there a role for primary medical therapy?

Role of Somatostatin Receptor Subtypes in Acromegaly

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