Treatment Outcome Results from the Bulgarian Acromegaly Database: Adjuvant Dopamine Agonist Therapy is Efficient in Less than One Fifth of Non-irradiated Patients

Abstract

DAs are efficient in less than 20% of non-irradiated patients. They are a good cost-effective alternative for carefully selected patients.

Treatment escape reduces the effectiveness of cabergoline during long‐term treatment of acromegaly in monotherapy or in association with first‐generation somatostatin receptor ligands

“…For CAB treatment in association with SRL, PRL levels were not different between controlled patients and noncontrolled patients. Our results are in agreement with most of the previous studies evaluating the influence of hyperprolactinemia in response to CAB treatment, which indicates a positive influence of CAB monotherapy but not of CAB with SRLs . A limitation of our study was the lack of availability of immunohistochemistry for prolactin, and cosecretion cannot be assumed in all cases as hyperprolactinemia may be due to pituitary stalk compression by the tumour mass .…”

“…Some studies have evaluated CAB in monotherapy for acromegaly treatment . However, some of these studies preselected patients according to response to previous treatment with DA, such as the study with the largest sample in the literature .…”

“…Some studies have evaluated CAB in monotherapy for acromegaly treatment. 10,13,15,[17][18][19][20][21][22][23][24][25] However, some of these studies preselected patients according to response to previous treatment with DA, 16,26,27 such as the study with the largest sample in the literature. 17 In addition, considering all of the single-centre studies published in the literature, only 151 patients treated with CAB monotherapy have been described.…”

“…In addition, most of these studies evaluated a short duration of treatment and a limited number of patients. [10][11][12][13][14][15][16] Therefore, in this study, we aimed to analyse the results of the use of CAB either in monotherapy or in combination with first-generation SRLs in a large group of acromegaly patients followed at a single reference centre.…”

Experience with pegvisomant treatment in acromegaly in a single Brazilian tertiary reference center: efficacy, safety and predictors of response

“…Pasireotide LAR, a next-generation SA (not yet approved for acromegaly treatment in Brazil), allows disease control in a higher percentage of patients and is effective in approximately 15% of those patients not controlled by first-generation SA with the dose of 40 mg and in 20% of the patients with the dose of 60 mg (12,13). The efficacy of cabergoline as monotherapy has not been evaluated in prospective studies, but normalization of IGF-I was reported in 34% of the patients in a meta-analysis of the literature, but can be as low as 10% in more recent studies, therefore, it is reserved for those patients with mildly elevated GH and IGF-I levels (4,(14)(15)(16). The efficacy of other DA, like bromocriptine, is probably lower than that of cabergoline (4).…”