Pregnancy outcome after treatment with the ergot derivative, cabergoline

Robert, Elisabeth; Musatti, L.; Piscitelli, G.; Ferrari, Carlo

doi:10.1016/0890-6238(96)00063-9

Cited by 155 publications

(56 citation statements)

References 9 publications

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“…The incidence of abortions, ectopic pregnancies or congenital malformations is no higher in infants born to mothers who conceived while taking bromocriptine than that in the general population [30,31]. Similar results have been reported with women who have taken cabergoline before and during pregnancy [32][33][34][35][36]. However, the number of pregnancies studied using cabergoline is still much smaller than for bromocriptine [30,31].…”

Section: Discussionsupporting

confidence: 76%

Management of prolactinomas in Brazil: an electronic survey

et al. 2010

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Dopamine agonists are the treatment of choice for prolactinomas. However, there are still controversies concerning dose, treatment duration and criteria for drug withdrawal in different clinical situations. The aim of this study was to assess diagnostic and therapeutic approaches to prolactinomas among members of the Brazilian Society of Endocrinology and Metabolism (SBEM). SBEM members answered a questionnaire sent by e-mail that included 18 questions related to controversial issues about the management of prolactinomas. Among SBEM members, 721 (approximately 24% of total) answered the questionnaire. Concerning the diagnosis, 38% of the respondents stated that prolactin levels < 100 ng/ml would exclude the presence of a prolactinoma. Most of them favored the screening for macroprolactin in asymptomatic individuals instead of a routine screening (74% vs. 26%). Regarding the treatment, 70% of the respondents chose cabergoline as the drug of choice to treat macroprolactinomas whereas similar proportions advised cabergoline or bromocriptine as the best treatment for microprolactinomas (52% vs. 48%). Only 20% and 34% of respondents favored treatment withdrawal 2-3 years after prolactin normalization in patients with macroprolactinomas and microprolactinomas, respectively. In case of pregnancy, only 58 and 70% of respondents advocated discontinuation of treatment with dopamine agonists in patients with macroprolactinomas and microprolactinomas, respectively. Finally, only 36% would allow breast-feeding without restriction, 44% would restrict it to patients with microprolactinomas and 20% would not recommend it for women with prolactinomas There are several points of disagreement among SBEM members regarding the management of prolactinomas.

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Section: Discussionsupporting

confidence: 76%

Management of prolactinomas in Brazil: an electronic survey

et al. 2010

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“…In animal models, DRD2-A inhibits pathologic angiogenesis in tumors (Basu et al 2004) by inactivating VEGFR2 signaling (Basu et al 2001). However, this type of medication has an acceptable safety profile and does not interfere with the normal establishment and progression of pregnancy (Robert et al 1996, Ricci et al 2002. We have previously used a well-established experimental endometriosis model to demonstrate that the DRD2-A cabergoline (Cb2) prevents the formation of typical endometriosis lesions by inhibiting angiogenesis (Novella-Maestre et al 2009).…”

Section: Introductionmentioning

confidence: 99%

The effects of ergot and non-ergot-derived dopamine agonists in an experimental mouse model of endometriosis

Delgado-Rosas¹,

Gómez²,

Ferrero³

et al. 2011

Reproduction

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Implantation of a retrogradely shed endometrium during menstruation requires an adequate blood supply, which allows the growth of endometriotic lesions. This suggests that the development of endometriosis can be impaired by inhibiting angiogenesis. The growth of endometriotic foci is impaired by commercial oncological antiangiogenic drugs used to block vascular endothelial growth factor (VEGF) signaling. The dopamine agonist cabergoline (Cb2) inhibits the growth of established endometriosis lesions by exerting antiangiogenic effects through VEGFR2 inactivation. However, the use of ergot-derived Cb2 is associated with an increased incidence of cardiac valve regurgitation. To evaluate the potential usage of non-ergot-derived dopamine agonists for the treatment of human endometriosis, we compared the efficacy of quinagolide with that of Cb2 in preventing angiogenesis and vascularization in a heterologous mouse model of endometriosis. Nude mice whose peritoneum had been implanted with eutopic human endometrial fragments were treated with vehicle, 50 mg/kg per day oral Cb2, or 50 or 200 mg/kg per day quinagolide during a 14-day period. At the end of the treatment period, the implants were excised in order to assess lesion size, cell proliferation, degree of vascularization, and angiogenic gene expression. Neoangiogenesis was inhibited and the size of active endometriotic lesions, cellular proliferation index, and angiogenic gene expression were significantly reduced by both dopamine agonists when compared with the placebo. Given that Cb2 and quinagolide were equally effective in inhibiting angiogenesis and reducing lesion size, these experiments provide the rationale for pilot studies to explore the use of non-ergot-derived dopamine agonists for the treatment of endometriosis in humans.

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“…We found only one low birth weight among infants of women treated with CAB, meanwhile Robert et al reported 6.8% [9], Colao et al 6.6% [10] and Ricci et al 12.2% [8], these data represent no increase in the risk of low birth weight [10]. Bronstein et al reported 2 premature infants in 6 patients who were treated with CAB [31].…”

Section: Discussionmentioning

confidence: 69%

“…In patients under CAB treatment, Robert et al reported 23 spontaneous abortions in 226 pregnancies [9], Ricci et al presented 9.8% of 61 pregnancies [8], and Colao et al reported 9% in 329 [10]. In the review of other published series of hyperprolactinemic women treated with CAB, we found 5 spontaneous abortions in 67 pregnancies of 514 women [19][20][21][22].…”

Section: Discussionmentioning

confidence: 77%

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Effects of cabergoline on pregnancy and embryo-fetal development: retrospective study on 103 pregnancies and a review of the literature

Stalldecker¹,

Mallea-Gil²,

Guitelman³

et al. 2010

Pituitary

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The aim of the study is to assess the rate of any potential adverse effects on women who became pregnant under cabergoline (CAB) treatment and to evaluate any effects on the embryo-fetal development and on children who were born from mothers exposed to CAB in early weeks of gestation. Observational, retrospective and multicenter study on 103 pregnancies in 90 women with hyperprolactinemia. All patients were under CAB at conception. Serum prolactin at baseline was between 30 and 1921 ng/ml. Duration of therapy before pregnancy ranged from 1 to 120 months and doses ranged from 0.125 to 5 mg/week. Fetal exposure ranged from 3 to 25 weeks, 96.9% of patients received CAB during the first trimester of pregnancy and the rest until the second one. No significant complications during pregnancy were found. Seven women (7.2%) had spontaneous abortions. Preterm deliveries were recorded in eight (8.8%), only one with low weight for gestational age. Neonatal abnormalities were observed in 3 (3.6%): 1 major (Down syndrome) and 2 minor malformations (umbilical and inguinal hernia). We were able to asses the children's development in 61. Two had epilepsy and two had Pervasive Developmental Disorder (PDD). No significantly higher frequency of complications was found in pregnancies and/or offspring exposed to CAB than in the normal population. We registered 2 abnormalities in the development of the children: epilepsy and PDD. Larger series of patients are needed to assess the safety of this drug during pregnancy.

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Pregnancy outcome after treatment with the ergot derivative, cabergoline

Cited by 155 publications

References 9 publications

Management of prolactinomas in Brazil: an electronic survey

Management of prolactinomas in Brazil: an electronic survey

The effects of ergot and non-ergot-derived dopamine agonists in an experimental mouse model of endometriosis

Effects of cabergoline on pregnancy and embryo-fetal development: retrospective study on 103 pregnancies and a review of the literature

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