Long-term treatment of acromegaly with bromocriptine.

Wass, John; Thorner, Michael O.; Morris, DL; Rees, Lesley; Mason, April C.; Jones, Arthur; Besser, G. M.

doi:10.1136/bmj.1.6065.875

Cited by 243 publications

(98 citation statements)

References 10 publications

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“…1,[12][13][14]22,46 Somatostatin analogs provide a more effective treatment option and can normalize IGF-I levels in 50 to 60% of patients. 3,8,9,11,24,36 The more recently introduced GH receptor antagonists appear to have encouraging prospects.…”

Section: Role Of Gks In Multimodal Therapymentioning

confidence: 99%

Stereotactic radiosurgery for hypersecreting pituitary tumors: part of a multimodality approach

Jane¹,

Vance²,

Woodburn³

et al. 2003

FOC

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Object Surgical and medical therapies successfully achieve biochemical remission in the majority of patients with secretory pituitary adenomas. Nevertheless, continued hypersecretion after first-line therapy occurs and requires adjunctive therapy to prevent morbidity and premature mortality. For patients in whom medical and surgical therapy have failed, gamma knife surgery (GKS) is performed with the goal of controlling tumor growth and excess growth hormone (GH) production. The authors report their experience with GKS in patients in whom surgical and medical therapies failed. Methods The neuroendocrine service at the University of Virginia has treated 220 patients with secretory adenomas. The authors evaluated the biochemical results in patients with acromegaly followed for greater than 18 months (64 patients) as well as those with Cushing disease (45 patients), Nelson syndrome (14 patients with adequate follow up [27 overall]), and prolactinomas (19 patients) followed for at least 12 months posttreatment. Biochemical remission occurred in 36% of patients with GH-secreting adenomas, 73% of those with Cushing disease, 14% of those with Nelson syndrome, and 11% of those harboring prolactinomas. Recurrence after biochemical remission was documented in four patients with Cushing disease. New hormonal deficits have occurred in 28% of patients with acromegaly, 31% with Cushing disease, 36% with Nelson syndrome, and 21% with prolactinomas. Minor visual deterioration developed in one patient with Cushing disease. Conclusions Gamma knife surgery offers an important treatment modality in patients with secretory adenomas refractory to surgical and medical interventions.

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Section: Role Of Gks In Multimodal Therapymentioning

confidence: 99%

Stereotactic radiosurgery for hypersecreting pituitary tumors: part of a multimodality approach

Jane¹,

Vance²,

Woodburn³

et al. 2003

FOC

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“…In contrast, the same maneuver has been shown to decrease serum GH levels in most, though not all, patients with acromegaly (3,(5)(6)(7)(8). On the basis ofthis finding, bromocriptine, a dopaminergic agonist with a prolonged action, has been successfully introduced into the medical management of this disorder (9)(10)(11)(12).…”

mentioning

confidence: 99%

Direct effects of catecholamines, thyrotropin-releasing hormone, and somatostatin on growth hormone and prolactin secretion from adenomatous and nonadenomatous human pituitary cells in culture.

Ishibashi¹,

Yamaji²

1984

J. Clin. Invest.

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A bstract. To determine the mechanism and the site of action of catecholamines as well as hormones including thyrotropin-releasing hormone (TRH)' and somatostatin on pituitary hormone release in patients with acromegaly and in normal subjects, the effects of these substances on growth hormone (GH) and prolactin (PRL) secretion from adenomatous and nonadenomatous human pituitary cells in culture were examined. When dopamine (0.01-0.1 tM) or bromocriptine (0.01-0.1 tM) was added to the culture media, a significant inhibition of GH

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“…As relatively large doses of bromocriptine are necessary to induce clinically beneficial effects [77] this drug is not so often used as a primary therapy for acromegaly, but more often as an adjuvant therapy [78]. In less than 20% of the patients, bromocriptine is capable of reducing growth-hormone levels to less than 5 F~g/I, while only in 8% of the patients normalization of IGF-I levels is achieved.…”

Section: Bromocriptinementioning

confidence: 99%