Article (Scientific journals)
Cabergoline in the treatment of hyperprolactinemia: a study in 455 patients.
Verhelst, Johan; Abs, Roger; Maiter, Dominique et al.
1999In Journal of Clinical Endocrinology and Metabolism, 84 (7), p. 2518-22
Peer Reviewed verified by ORBi
 

Files


Full Text
Cabergoline in the Treatment of Hyperprolactinemia - A Study in 455 Patients.pdf
Publisher postprint (1.17 MB)
Download

All documents in ORBi are protected by a user license.

Send to



Details



Keywords :
Adenoma/blood/drug therapy/pathology; Adult; Antineoplastic Agents/therapeutic use; Bromocriptine/adverse effects/therapeutic use; Dopamine Agonists/therapeutic use; Drug Resistance; Drug Tolerance; Ergolines/adverse effects/therapeutic use; Female; Humans; Hyperprolactinemia/drug therapy; Male; Middle Aged; Pituitary Neoplasms/blood/drug therapy/pathology; Pregnancy; Retrospective Studies; Sex Characteristics
Abstract :
[en] Cabergoline is a new long-acting dopamine agonist that is very effective and well tolerated in patients with pathological hyperprolactinemia. The aim of this study was to examine, in a very large number of hyperprolactinemic patients, the ability to normalize PRL levels with cabergoline, to determine the effective dose and tolerance, and to assess the effect on clinical symptoms, tumor shrinkage, and visual field abnormalities. We also evaluated the effects of cabergoline in a large subgroup of patients with bromocriptine intolerance or -resistance. We retrospectively reviewed the files of 455 patients (102 males and 353 females) with pathological hyperprolactinemia treated with cabergoline in 9 Belgian centers. Among these patients, 41% had a microadenoma; 42%, a macroadenoma; 16%, idiopathic hyperprolactinemia; and 1%, an empty sella. The median pretreatment serum PRL level was 124 microg/L (range, 16-26,250 microg/L). A subgroup of 292 patients had previously been treated with bromocriptine, of which 140 showed bromocriptine intolerance and 58 showed bromocriptine resistance. Treatment with cabergoline normalized serum PRL levels in 86% of all patients: in 92% of 244 patients with idiopathic hyperprolactinemia or a microprolactinoma and in 77% of 181 macroadenomas. Pretreatment visual field abnormalities normalized in 70% of patients, and tumor shrinkage was seen in 67% of cases. Side effects were noted in 13% of patients, but only 3.9% discontinued therapy because of side effects. The median dose of cabergoline at the start of therapy was 1.0 mg/week but could be reduced to 0.5 mg/week once control was achieved. Patients with a macroprolactinoma needed a higher median cabergoline dose, compared with those with idiopathic hyperprolactinemia or a microprolactinoma: 1.0 mg/week vs. 0.5 mg/week, although a large overlap existed between these groups. Twenty-seven women treated with cabergoline became pregnant, and 25 delivered a healthy child. One patient had an intended abortion and another a miscarriage. In the patients with bromocriptine intolerance, normalization of PRL was reached in 84% of cases, whereas in the bromocriptine-resistant patients, PRL could be normalized in 70%. We confirmed, in a large-scale retrospective study, the high efficacy and tolerability of cabergoline in the treatment of pathological hyperprolactinemia, leaving few patients with unacceptable side effects or inadequate clinical response. Patients with idiopathic hyperprolactinemia or a microprolactinoma, on average, needed only half the dose of cabergoline as those with macroprolactinomas and have a higher chance of obtaining PRL normalization. Cabergoline also normalized PRL in the majority of patients with known bromocriptine intolerance or -resistance. Once PRL secretion was adequately controlled, the dose of cabergoline could often be significantly decreased, which further reduced costs of therapy.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Verhelst, Johan
Abs, Roger
Maiter, Dominique
van den Bruel, Annick
Vandeweghe, Mark
Velkeniers, Brigitte
Mockel, Jean
Lamberigts, Gérard
Petrossians, Patrick  ;  Centre Hospitalier Universitaire de Liège - CHU > Endocrinologie clinique
Coremans, Peter
Mahler, Charles
Stevenaert, Achille ;  Centre Hospitalier Universitaire de Liège - CHU > Neurochirurgie
Verlooy, Jan
Raftopoulos, Christian
Beckers, Albert ;  Université de Liège - ULiège > Département des sciences cliniques > Endocrinologie
More authors (5 more) Less
Language :
English
Title :
Cabergoline in the treatment of hyperprolactinemia: a study in 455 patients.
Publication date :
December 1999
Journal title :
Journal of Clinical Endocrinology and Metabolism
ISSN :
0021-972X
eISSN :
1945-7197
Publisher :
Endocrine Society, Chevy Chase, United States - Maryland
Volume :
84
Issue :
7
Pages :
2518-22
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 18 March 2010

Statistics


Number of views
384 (5 by ULiège)
Number of downloads
1425 (2 by ULiège)

Scopus citations®
 
396
Scopus citations®
without self-citations
365
OpenCitations
 
227

Bibliography


Similar publications



Contact ORBi