The efficacy and tolerability of long‐term cabergoline therapy in hyperprolactinaemic disorders: an open, uncontrolled, multicentre study

Webster, Jonathan; Piscitelli, G.; Polll, A.; D'Alberton, A; Falsetti, L.; Ferrari, Carlo; Fioretti, P.; Giordano, Giulio; L’Hermite, Marc; Ciccarelli, Enrica; Crosignani, Pier Giorgio; Dececco, L; Fadini, Rubens; Faglia, G.; Flamigni, Carlo; Tamburrano, G.; Ismail, I.A.; Scanlon, M. F.

doi:10.1111/j.1365-2265.1993.tb02372.x

Cited by 61 publications

(26 citation statements)

References 21 publications

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“…The weekly dosage of cabergoline was reported to be 0.5-3.0 mg with the maximum dose being less than 3.5 mg/wk in most institutions of Western countries (4 -7, 9 -17). For instance, three independent investigators ͓Webster et al (4,10), Muratori et al (12), and Colao et al (7,13,(15)(16)(17)͔ used 0.5-1.0, 0.5-3.0, and 0.5-3.5 mg/wk. Cabergoline at doses greater than 4 mg/wk has rarely been used to treat hyperprolactinemia.…”

Section: Discussionmentioning

confidence: 98%

Prospective Study of High-Dose Cabergoline Treatment of Prolactinomas in 150 Patients

Ono

Miki

Kawamata

et al. 2008

The Journal of Clinical Endocrinology &Amp; Metabolism

162

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Section: Discussionmentioning

confidence: 98%

Prospective Study of High-Dose Cabergoline Treatment of Prolactinomas in 150 Patients

Ono

Miki

Kawamata

et al. 2008

The Journal of Clinical Endocrinology &Amp; Metabolism

162

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“…Significant decreases in serum PRL levels occur in as many as 95% of hyperprolactinemic women during chronic cabergoline treatment at a dose of 1 mg twice weekly (202). In a multicenter, randomized, 24-wk trial conducted in 459 hyperprolactinemic women (203), cabergoline induced normal PRL levels in 83% compared with 59% with bromocriptine; ovulatory cycles or pregnancies were recorded in 72% vs. 52%, and side effects were less frequent, less severe, and shorter lived.…”

Section: Cabergolinementioning

confidence: 97%

“…In head-to-head randomized, prospective comparison studies (202), retrospective analyses (207), and general clinical experience, cabergoline has been shown to be more effective in lowering PRL levels to normal, reducing tumor size, and having less adverse effects. As noted below, patients are less likely to be resistant to the therapeutic effects of cabergoline; furthermore, most patients found to be resistant to bromocriptine subsequently respond to cabergoline.…”

Section: E Conclusion With Regard To Medical Therapymentioning

confidence: 97%

Advances in the Treatment of Prolactinomas

et al. 2006

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Prolactinomas account for approximately 40% of all pituitary adenomas and are an important cause of hypogonadism and infertility. The ultimate goal of therapy for prolactinomas is restoration or achievement of eugonadism through the normalization of hyperprolactinemia and control of tumor mass. Medical therapy with dopamine agonists is highly effective in the majority of cases and represents the mainstay of therapy. Recent data indicating successful withdrawal of these agents in a subset of patients challenge the previously held concept that medical therapy is a lifelong requirement. Complicated situations, such as those encountered in resistance to dopamine agonists, pregnancy, and giant or malignant prolactinomas, may require multimodal therapy involving surgery, radiotherapy, or both. Progress in elucidating the mechanisms underlying the pathogenesis of prolactinomas may enable future development of novel molecular therapies for treatment-resistant cases. This review provides a critical analysis of the efficacy and safety of the various modes of therapy available for the treatment of patients with prolactinomas with an emphasis on challenging situations, a discussion of the data regarding withdrawal of medical therapy, and a foreshadowing of novel approaches to therapy that may become available in the future.

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“…However, up to 12% of these patients did not tolerate the drug in therapeutic doses because of side effects and 5-10% of patients showed only minimal or no response after bromocriptine therapy (8,9). Cabergoline, a long-acting dopamine agonist, has been shown to be more effective (83%) (8) than bromocriptine with a marked reduction in adverse effects (7,8,(10)(11)(12)(13)(14)(15). Thus, cabergoline and also quinagolide started to progressively replace bromocriptine in the medical therapy of prolactinomas during the last decade (16)(17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Operative treatment of prolactinomas: indications and results in a current consecutive series of 212 patients

Kreutzer¹,

Buslei²,

Wallaschofski³

et al. 2008

European Journal of Endocrinology

160

102

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Objective: Medical therapy with dopamine agonists (DA) is the primary treatment of choice in most patients with prolactinomas. 'Classical' surgical indications are intolerance or lack of efficiency of DA therapy. Focusing on a possible shift of recent indications, we retrospectively analyzed our results of surgical treatment in prolactinomas. Patients and methods: Between 1990 and 2005, we have operated on 212 consecutive patients with prolactinomas. Surgical indications were divided into 'classical' indications and 'modern' indications defined as cystic prolactinomas or patients with microprolactinomas who individually decided on a primary surgical treatment. Results: Initial overall remission was accomplished in 53.2% including giant prolactinomas. However, in microadenomas, the remission rate was significantly higher with 91.3%. Overall remission at the latest follow-up was 42.7%, but 72.5% in intrasellar tumors, 80% in cystic prolactinomas, and 84.8% in microprolactinomas. The overall recurrence rate was 18.7%. Relapse of hyperprolactinemia in microprolactinomas was 7.1%. In our series, continually less patients were surgically treated for 'classical' indications. By contrast, the number of patients who individually decided on a primary surgical therapy has increased considerably. Conclusion: Remission rates after surgical treatment of prolactinomas remain excellent, particularly in microadenoma and intrasellar macroadenomas, whereas morbidity of transsphenoidal surgery is low in the hands of experienced pituitary surgeons. Our remission rates not only confirm the already interdisciplinarily accepted surgical indications, but also emphasize the value of primary transsphenoidal surgery as a discussion-worthy alternative to dopaminergic therapy in young patients with microprolactinomas or cystic tumors.

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The efficacy and tolerability of long‐term cabergoline therapy in hyperprolactinaemic disorders: an open, uncontrolled, multicentre study

Cited by 61 publications

References 21 publications

Prospective Study of High-Dose Cabergoline Treatment of Prolactinomas in 150 Patients

Prospective Study of High-Dose Cabergoline Treatment of Prolactinomas in 150 Patients

Advances in the Treatment of Prolactinomas

Operative treatment of prolactinomas: indications and results in a current consecutive series of 212 patients

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