Cabergoline addition to depot somatostatin analogues in resistant acromegalic patients: efficacy and lack of predictive value of prolactin status

Cozzi, Renato; Attanasio, Roberto; Lodrini, S.; Lasio, Giovanni

doi:10.1111/j.1365-2265.2004.02082.x

Cited by 150 publications

(97 citation statements)

References 32 publications

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“…A recruitment bias of previous studies is the inclusion of most patients with concomitant hyperprolactinaemia. More recently, Cozzi et al (24) reported that the addition of cabergoline, using the minimal effective and the maximal tolerated dose (range 1-3.5 mg/week), significantly decreased GH and IGF-I levels after 6 months (Fig. 2); in this study, results were not dependent on PRL status (serum levels or immunohistochemistry).…”

Section: Gh-secreting Tumourssupporting

confidence: 53%

“…Subsequent in vivo studies have confirmed that the combination of somatostatin analogues and dopamine agonists is more effective than somatostatin analogues alone in reducing GH levels in patients with GH-secreting adenomas resistant to somatostatin analogues (17,(19)(20)(21)(22)(23)(24)(25).…”

Section: Gh-secreting Tumoursmentioning

confidence: 99%

“…The use of a combined somatostatin analogue and dopamine agonist treatment schedule seems to be of particular interest in growth hormone (GH)-secreting adenomas that are known to be potentially responsive to both classes of compounds (16)(17)(18)(19)(20)(21)(22)(23)(24)(25). More recently, nonfunctioning pituitary adenomas were shown to be sensitive to a combined treatment, whereas the response rate to somatostatin analogues or dopamine agonists alone is limited.…”

Section: Introductionmentioning

confidence: 99%

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Combined therapy of somatostatin analogues and dopamine agonists in the treatment of pituitary tumours

Colao

Filippella²,

Pivonello

et al. 2007

eur j endocrinol

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Pituitary tumours express both somatostatin and dopamine receptors. Medical treatment with somatostatin analogues is a cornerstone of GH-and TSH-secreting tumours, while treatment with dopamine agonists is a cornerstone of prolactin-secreting tumours. Dopamine agonists have also demonstrated some efficacy in patients with GH-and TSH-secreting adenomas. Neither ACTHsecreting nor clinically non-functioning tumours have a well-established medical treatment. Nevertheless, some recent results have indicated a potential usefulness of the dopamine agonist cabergoline in patients with pituitary-dependent Cushing's disease. Combination treatment with both somatostatin analogues and dopamine agonists has been poorly investigated. Some studies conducted in small series have documented an additive effect of both drugs in patients with GH-secreting adenomas. Of mention is that none of the studies were randomised and cross-sectional so that the results should be confirmed by other well-designed studies. No data are available in other pituitary tumour histotypes. Preliminary observations in patients with clinically non-functioning adenomas are very promising.

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Section: Gh-secreting Tumourssupporting

confidence: 53%

Section: Gh-secreting Tumoursmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Combined therapy of somatostatin analogues and dopamine agonists in the treatment of pituitary tumours

Colao

Filippella²,

Pivonello

et al. 2007

eur j endocrinol

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“…Therefore, the addition of CAB to the treatment of these patients has been proposed and has been reported in eight studies ( Table 1); none of these studies was a randomized or placebo-controlled trial [6,[22][23][24][25][26][27][28]. The maximal duration of follow-up was 24 months.…”

Section: Cab In Conjunction With Ssasmentioning

confidence: 99%

Cabergoline treatment in acromegaly: cons

Kasuki

Neto

2014

Endocrine

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Many options are available for the treatment of acromegaly, including surgery, radiotherapy, and medical treatment. Cabergoline (CAB), a dopamine agonist with high affinity for dopamine receptor type 2, has been used both in monotherapy and in conjunction with somatostatin analogs (SSAs). Although it is administered orally and has a relatively lower-cost in comparison with SSAs, few studies have demonstrated its usefulness, there is a lack of randomized-controlled trials and other drugs (SSAs and pegvisomant) with more data in the literature are available; these issues are the main drawbacks of adopting CAB for the treatment of acromegaly.

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“…Cabergoline was the dopamine agonist considered in the model, with effi cacy of 37% (13). Regarding the association of somatostatin analogues and cabergoline, the effi cacy data available combines data from both octreotide LAR and lanreotide SR. Because of that the same effi cacies (21% for GH and 42% for IGF-I normalizations) were used for the association of cabergoline with any somatostatin analogue (19).…”

Section: Cea Of Somatostatin Analogues In Acromegalymentioning

confidence: 99%

Cost-effectiveness analysis of somatostatin analogues in the treatment of acromegaly in Brazil

Valentim

Passos

Mataveli

et al. 2008

Arq Bras Endocrinol Metab

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This study aims to compare economic and patient impacts of the treatment of acromegaly with two different somatostatin analogues (octreotide LAR and lanreotide SR) in Brazil. A cost-effectiveness analysis was carried out under the Brazilian Public Health Care System (SUS) perspective. A decision analytical model was developed based on the Brazilian Public Health Care System Clinical Guideline for Acromegaly. A hypothetical cohort of 276 patients was followed for two years. Data were extracted from literature and administrative databases. Based on the analytical model, treatment with octreotide LAR would avoid 12 and 17 cases of GH and IGF-I elevated serum levels, respectively. Octreotide

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Cabergoline addition to depot somatostatin analogues in resistant acromegalic patients: efficacy and lack of predictive value of prolactin status

Abstract: The addition of cabergoline to depot SA-resistant acromegalic patients is effective, not dependent on PRL values and normalizes IGF-I levels in 42% of patients. The association of long-acting DA and SA deserves a more relevant role in the therapeutical algorithm of acromegaly.

Cited by 150 publications

References 32 publications

Combined therapy of somatostatin analogues and dopamine agonists in the treatment of pituitary tumours

Combined therapy of somatostatin analogues and dopamine agonists in the treatment of pituitary tumours

Cabergoline treatment in acromegaly: cons

Cost-effectiveness analysis of somatostatin analogues in the treatment of acromegaly in Brazil

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