Endocrine Abstracts

Background: Dopamine agonists (DAs) are the primary treatment for both microprolactinomas and macroprolactinomas. Two medications are FDA approved for the medical treatment of prolactinomas: cabergoline and bromocriptine. Although bromocriptine is deemed a secondary option after cabergoline, its lower cost may be a consideration for some patients. The purpose of this study is to analyze patients treated with different DAs during 12 months period and to identify the unchangeable factors that might predict the remission.

Methods: We retrospectively evaluated 89 patients with the diagnosis of prolactinoma who had been treated with dopamine agonists at Vilnius University Santaros Clinics in the year of 2016. The patients were divided into two groups, according to whether biochemical remission was achieved after 12 months of treatment, or not, and the factors that might predict possible remission were analyzed. Patients, treated with both drugs: cabergoline and bromocriptine or with surgery during 12 months period were excluded.

Results: Sixty-six patients (52 women and 14 men) with a mean age of 19–76 years were studied. 44 patients (66.7%) were treated with bromocriptine, while 22 (33.3%) with cabergoline. 46 patients (69.7%) achieved remission after 12 months of treatment while 20 patients (30.3%) did not. 75% of patients used bromocriptine in a group where remission was not achieved while in the remission group bromocriptine was used for 56.5% of patients. Patients who achieved remission were younger: on average 38.5 years old, while other 41.1 years old, also the initial prolactin level was 8.82 time lower in the remission group.

Conclusion: Although more patients who were treated with cabergoline achieved a positive outcome, it is not statistically significant that cabergoline increases the chance of remission. Possible unchangeable factors that might predict the positive outcomes like the age, a smaller size of the tumor or a lover prolactin level before starting the treatment are not statistically significant either.