Treatment of prolactin-secreting macroadenomas with the once-weekly dopamine agonist cabergoline.

Molitch, Mark E.; Vance, Mary Lee; Cannistraro, Kristin Baker; Davis, Kenneth R.; Simons, J.A.; Schoenfelder, John R.; Klibanski, Anne

doi:10.1210/jcem.81.6.8964874

Cited by 98 publications

(84 citation statements)

References 19 publications

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“…The 50% success rate weobserved for macroprolactinomatreated with bromocriptine is lower than those of several studies (62-67%) which administered higher doses or a long-acting injectable form of bromocriptine in macroprolactinoma patients (2 1-23). On the other hand, the 85%normalization rate we found in idiopathic + microprolactinoma patients in the cabergoline group is comparable to the results of Webster et al ( 15) (83%, 88%, 93% and 96%, respectively), and the 75% normalization rate we found in macroprolactinoma patients is in accordance with the results of Ferrari et al (26), Biller et al (27) and Colao et al (28) (61%, 73% and 81%, respectively), and lower than the 100%rate reported by Cannavo et al (24), who used a higher dose of cabergoline (i.e. 3 mg/week).…”

Section: Discussionsupporting

confidence: 92%

Comparison of the Effects of Cabergoline and Bromocriptine on Prolactin Levels in Hyperprolactinemic Patients.

et al. 2001

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Objective It is well knownthat bromocriptine has a suppressive effect on the prolactin release in hyperprolactinemic patients. But it also has someadverse effects. The new, long-acting dopaminergic drug, cabergoline, has been reported to be an effective agent in these patients. However, there are relatively few reports comparing the beneficial and adverse effects of these drugs in the treatment of hyperprolactinemic patients. Therefore, here we studied and compared the efficacy and tolerability of cabergoline with bromocriptine in hyperprolactinemic patients.Patients Seventeen patients (7 with microprolactinoma, 4 with macroprolactinoma, 6 with idiopathic hyperprolactinemia) were given bromocriptine at a dose of 2.5 mg (or 5 mgfor macroprolactinomas) twice daily, and 17 patients (8 with microprolactinoma, 4 with macroprolactinoma, 5 with idiopathic hyperprolactinemia) were given cabergoline at a dose of 0.5 mg twice weekly for 12 weeks. Results At the end of the study, the prolactin reduction was significantly greater in the cabergoline group than in the bromocriptine group (-93 vs. -87.5%, respectively, p<0.05). Normalization of prolactin levels was achieved in 10 of 17 patients (59%) in the bromocriptine group, and in 14 of 17 patients (82%) in the cabergoline group (p=0.13).Twopatients (50%) with macroprolactinoma in the bromocriptine group and three patients (75%) with macroprolactinoma in the cabergoline group demonstrated a normalization of their serum prolactin levels. Adverse events were noted in 53%of bromocriptine patients and in 12% of cabergoline patients (p<0.01). Conclusion These data indicate that cabergoline is a very effective agent for lowering the prolactin levels in hyperprolactinemic patients and that it appears to offer considerable advantage over bromocriptine in terms of efficacy and tolerability.

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Section: Discussionsupporting

confidence: 92%

Comparison of the Effects of Cabergoline and Bromocriptine on Prolactin Levels in Hyperprolactinemic Patients.

et al. 2001

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“…Of these, cabergoline, a longacting D2-selective dopamine agonist, has been found to be highly effective in normalizing PRL levels and inducing shrinkage of micro-and macroprolactinomas in both men and women (7)(8)(9)(10)(11)(12). Today, surgery is recommended for prolactinoma only in patients with an inadequate response to dopamine agonists (13).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of long-term cabergoline treatment for giant prolactinoma: study of 12 men

Shimon¹,

Benbassat²,

Hadani³

2007

eur j endocrinol

101

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Objective: To review our experience with cabergoline, a D2-selective dopamine agonist, for the treatment of giant prolactinomas. Design: A retrospective case series; descriptive statistics. Methods: The study group included 12 men aged 24-52 years (mean 39.2 years) treated for giant prolactinoma at our centers from 1997 to 2006. Cabergoline was started at a dose of 0.5 mg/three times a week and progressively increased as necessary to up to 7 mg/week. Patients were followed by hormone measurements, sellar magnetic resonance imaging, and visual examinations. Results: In ten patients, cabergoline served as first-line therapy. The other two patients had previously undergone transsphenoidal partial tumor resection because of visual deterioration. Mean serum prolactin level before treatment was 14 393G14 579 ng/ml (range 2047-55 033 ng/ml; normal 5-17 ng/ml). Following treatment, levels normalized in ten men within 1-84 months (mean, 25.3 months) and decreased in the other two to 2-3 times of normal. Tumor diameter, which measured 40-70 mm at diagnosis, showed a mean maximal decrease of 47G21%; response was first noted about 6 months after the onset of treatment. Nine patients had visual field defects at diagnosis; vision returned to normal in three of them and improved in five. Testosterone levels, initially low in all patients, normalized in eight. There were no side effects of treatment. Conclusion: Cabergoline therapy appears to be effective and safe in men with giant prolactinomas. These findings suggest that cabergoline should be the first-line therapy for aggressive prolactinomas, even in patients with visual field defects.European Journal of Endocrinology 156 225-231

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“…CAB is characterized by a duration of action as long as 21 days after a single oral dose of 0.3±1 mg (11±14). Moreover, CAB has been shown to be more effective and better tolerated than BRC in a multicenter, randomized 24-week trial in 459 hyperprolactinemic women (15) and in a few patients with macroprolactinoma (16).…”

Section: Introductionmentioning

confidence: 99%

Cabergoline treatment rapidly improves gonadal function in hyperprolactinemic males: a comparison with bromocriptine

Rosa

Colao

Sarno

et al. 1998

European Journal of Endocrinology

120

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This study evaluated the effects of chronic treatment with cabergoline (CAB), a new, potent and longlasting ergoline-derived dopamine agonist, on seminal¯uid parameters and sexual and gonadal function in hyperprolactinemic males in comparison with the effect of bromocriptine (BRC) treatment.Seventeen males with macroprolactinoma were treated with CAB at a dose of 0.5±1.5 mg/week (n 7), or BRC at a dose of 5±15 mg/day (n 10) for 6 months. Baseline prolactin (PRL) was 925.7 6 522.6 mg/l in the CAB-treated group and 1059.4 6 297.6 mg/l in the BRC-treated group. All the patients suffered from libido impairment, ten from reduced sexual potency, and six had infertility. In ®ve patients provocative bilateral galactorrhea was found.Seminal¯uid analysis, functional seminal tests and penis rigidity and tumescence, measured by nocturnal penile tumescence (NPT) using Rigiscan equipment, were assessed before and after 1, 3 and 6 months of CAB or BRC treatment. Hormone pro®les were assessed before and after 15, 30, 60, 90 and 180 days of both treatments.Before treatment, all patients had a low sperm count with oligoasthenospermia, reduced motility and rapid progression with an abnormal morphology and decreased viability, and a low number of erections. After 1 month, serum PRL levels were signi®cantly reduced in both groups of patients (20.6 6 6.6 mg/l during CAB and 256.3 6 115

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Treatment of prolactin-secreting macroadenomas with the once-weekly dopamine agonist cabergoline.

Cited by 98 publications

References 19 publications

Comparison of the Effects of Cabergoline and Bromocriptine on Prolactin Levels in Hyperprolactinemic Patients.

Comparison of the Effects of Cabergoline and Bromocriptine on Prolactin Levels in Hyperprolactinemic Patients.

Effectiveness of long-term cabergoline treatment for giant prolactinoma: study of 12 men

Cabergoline treatment rapidly improves gonadal function in hyperprolactinemic males: a comparison with bromocriptine

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