Bromocriptine Therapy in Acromegaly

Sachdev, Y; Tunbridge, W. M. G.; Weightman, D.; Gómez-Pan, A.; Duns, A.; Hall, R.; Goolamali, S.K.

doi:10.1016/s0140-6736(75)92655-0

Cited by 108 publications

(36 citation statements)

References 24 publications

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“…However, there are few studies in which both GH and IGF-I data are available to assess remission with these agents. Using GH measurements alone, values below 2.5 µg/l are found during treatment with bromocriptine in 5–17% of patients [102, 103, 104]. Serum IGF-I is normalized in about 10% of patients [105].…”

Section: Results Of Treatment Of Acromegaly Using Defined Gh and Igf-mentioning

confidence: 99%

Treatment of Acromegaly

Holdaway

2004

Horm Res Paediatr

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Mortality is increased in individuals with acromegaly unless serum growth hormone (GH) levels are below 2 µg/l and serum insulin-like growth factor (IGF)-I levels are normal following treatment. These combined criteria have been used to define remission of the disorder in this review. Transsphenoidal surgery achieves remission targets in an average of 55% of patients. For those not in remission following surgery, options include repeat surgery or use of adjuvant therapy. Fractionated external beam pituitary radiotherapy achieves 10-year remission rates of 47% but leaves patients exposed to excess GH until remission occurs. Stereotactic radiotherapy and gamma knife radiosurgery achieve remission rates of 40% over 3 years, and dopamine agonists produce remission in about 20% of patients. Somatostatin analogues induce remission in 59% of patients within the first year of treatment. The GH receptor antagonist pegvisomant leads to remission in 90% of patients, using IGF-I levels for assessment. Optimal treatment for a patient with acromegaly thus depends on the likely efficacy of treatment, cost, surgical skill, severity of side effects, tolerability, control of tumour growth, and improvement in complications related to tumour mass. A primary surgical approach, followed by medical therapy for those not in remission, remains the preferred option in most centres.

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Section: Results Of Treatment Of Acromegaly Using Defined Gh and Igf-mentioning

confidence: 99%

Treatment of Acromegaly

Holdaway

2004

Horm Res Paediatr

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“…At this point, it must be reminded that in acrome galia, STH secretion is inhibited by bromocryptine as Chiodmi el al. (1975) and Sachdev et al (1975) have reported.…”

Section: Discussionmentioning

confidence: 95%

Changes in Pituitary Hormones Serum Levels in Bromocryptine-Treated Parkinsonian Patients

Polleri¹,

Carolei²,

Rolandi³

et al. 1977

Neuropsychobiology

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In the course of a clinical trial with 2α-bromoergocryptine in Parkinson’s disease, the serum levels of several pituitary hormones have been studied in the assumption that the drug active on nigro-striatal dopaminergic system might also interfere with hypothalamus-protuberantial neurotransmission, and have effects on the function of the pituitary. No changes in serum levels of FSH, LH, STH and TSH were detected for every dose of the drug employed. Only prolactin serum levels diminished since the beginning of the treatment, the decrease being significant (p < 0.05 and p < 0.01). This effect on prolactin does not change in the dose range considered. Clinical improvement was observed for doses of drugs above 15 mg/day, whereas the effect on prolactin secretion occurred with the dose of 7.5 mg/day.

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“…The dopaminergic agent bromocriptine has been effectively used in reducing GH levels in acromegalic patients [22][23][24], which largely reflects direct effects at the pituitary level. Because DDTC augments endogenous dopamine, it is possible that an efflux of this neurotransmitter into the portal system could also lead to a direct inhibition of GH release at the level of the so matotroph.…”

Section: Discussionmentioning

confidence: 99%

Effects of Inhibition of Norepinephrine Synthesis on Spontaneous and Growth Hormone-Releasing Hormone-Induced GH Secretion in Cynomolgus Macaques: Evidence for Increased Hypothalamic Somatostatin Tone

et al. 1990

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To define the role of noradrenergic regulation of growth hormone (GH) secretion in a primate species, spontaneous and GH-releasing hormone (GHRH) stimulated GH secretion was studied in 6 chronically catheterized adult male cynomolgus monkeys before and after inhibition of norepinephrine synthesis. Blood samples were obtained at 15-min intervals during an 8-hour period to characterize the pattern of GH secretion, and the GH response to GHRH, 10 µg/kg i.v., was determined. These measurements were repeated 2 weeks later, 2 h after the intravenous administration of 12.5 mg/kg of the dopamine-β-hydroxylase inhibitor diethyldithiocarbamate (DDTC), which has been shown to be an effective norepinephrine synthesis inhibitor in the rat. Spontaneous and stimulated GH secretory patterns before and after DDTC administration were compared. Both the frequency and the amplitude of spontaneous GH pulses were markedly reduced by DDTC [3.8 ± 0.4 before vs. 1.8 ± 0.4 peaks/8 h after DDTC (p < 0.005) and 5.5 ± 0.7 vs. 2.0 ± 0.6 ng/ml (p < 0.01)]. Areas under the curve were also reduced by DDTC treatment [10.8 ± 1.0 vs. 5.7 ± 1.1 ng · h/ml (p < 0.01)], and DDTC administration diminished the peak GH responses to GHRH [12 ± 6 vs. 4 ± 2 ng/ml (p < 0.05)]. These results are consistent with the belief that DDTC is a potent inhibitor of spontaneous and GHRH-induced GH secretion. The action of DDTC could be mediated by a reduction in GHRH due to reduced norepinephrine synthesis, by an increase in somatostatin release through a dopaminergic stimulus, or by a direct dopaminergic effect on somatotrophs.

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Bromocriptine Therapy in Acromegaly

Cited by 108 publications

References 24 publications

Treatment of Acromegaly

Treatment of Acromegaly

Changes in Pituitary Hormones Serum Levels in Bromocryptine-Treated Parkinsonian Patients

Effects of Inhibition of Norepinephrine Synthesis on Spontaneous and Growth Hormone-Releasing Hormone-Induced GH Secretion in Cynomolgus Macaques: Evidence for Increased Hypothalamic Somatostatin Tone

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