ECE2017 Eposter Presentations: Pituitary and Neuroendocrinology Pituitary - Clinical (145 abstracts)
The use of increasing doses of cabergoline in the management of cabergoline-resistant prolactinomas
Lucio Vilar 1, , Clarice Vilar 2 , José Luciano Albuquerque 1 , Patricia Gadelha 1 , Ana Carolina Thé 1 , Erik Trovão 1 , Thaíse Borges 1 , Izabela Cardoso 1 & Ruy Lyra 1
1Division of Endocrinology, Hospital das Clinicas, Federal University of Pernambuco, Recife (Pernambuco), Brazil; 2Endocrine Research Center of Pernambuo, Recife (Pernambuco), Brazil.
Introduction: Dopamine agonists (DA) are the ideal treatment for prolactinomas and cabergoline (CAB) is the drug of choice, for being much more effective and better tolerated than bromocriptine. However, 10-15% of patients with prolactinomas are considered to be resistant to CAB, as they dot not achieve prolactin (PRL) normalization, while in use of conventional doses of this drug.
Objective: To evaluate the effiaccy of increasing doses of CAB in prolactinomas refractory to CAB 3 mg/wk by in order to achieve prolactin (PRL) normalization.
Patients and methods: We prospectively evaluated the management of consecutive patients with prolactinomas refractory to CAB 3 mg/wk who were submitted to progressive increases in CAB dose, as needed and tolerated every 3 months, up to 9 mg/week. The patients were recruited over a 12-month period. Exclusion criteria were previous pituitary surgery or radiotherapy. Echocardiogram evaluation was performed in each patient every 6 months.
Results: Twenty five patients were included in this study, 20 with macroprolactinomas. Overall, normalization of PRL levels was achieved in 18 patients (72%): in 3 (12%) with a dose up to 4 mg/wk, in 9 (36%) with 5 mg/wk and in 6 (24%) with 6–7 mg/wk. No patients benefited from doses >7 mg/wk. No significant echocardio-graphic valve abnormalities were detected.
Conclusion: CAB doses up to 7 mg/wk were well tolerated and enabled PRL normalization in 18 (72%) patients with prolactinomas resistant to CAB 3 mg/wk. No patients benefited from doses >7 mg/wk.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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