ECE2018 Guided Posters Pituitary Clinical (12 abstracts)
The role of clomiphene citrate in the resolution of hypogonadism in male patients with prolactinomas under cabergoline therapy
Lucio Vilar , Clarice Vilar , Ruy Lyra , Ana Carolina Thé , Erik Trovao , Patricia Gadelha , Izabela Cardozo , Thaize Borges , Icaro Sampaio , Liana Ferreira & Luciano Albuquerque
Division of Endocrinology, Hospital das Clinicas, Federal University of Pernambuco, Recife, Brazil.
Background: Dopamine agonists (DA) are the treatment of choice of prolactinomas. Cabergoline is preferable to bromocriptine due to its greater effectiveness and better tolerabilitiy. However, up to 30–50% of male patients may persist with low levels of testosterone despite prolactin (PRL) normalization under DA therapy or the use of the maximum tolerated dose of DA. The aim of this prospective open study was to evaluate the efficacy of the SERM clomiphene citrate (CC) in these cases.
Subjects and methods: The aim of this prospective study was to evaluate the efficacy of CC in normalizing total testosterone (TT) in prolactinomas patients with persistent hypogonadotropic hypogonadism (HH) despite the use of CAB in weekly doses of up to 3 mg/week. TT, estradiol (E2), LH, FSH, and PRL were measured before and 4, 8, and 12 weeks after CC. Erectile function and hypogonadism symptoms were evaluated before and after CC. Persistent HH was defined by TT levels <300 ng/dl, along with either normal/low LH and FSH levels after at least 6 months of DA therapy. Response to CC was defined as TT levels ≥300 ng/dl.
Results: Eighteen patients (72%), 10 hyperprolactinemic and 8 normoprolactinemic, responded to clomiphene (TT≥300 ng/dl). Their mean TT levels were 234.1±36.6 ng/dl before CC and 390.1±38.9 ng/dl 12 weeks later (P<0.01). Significant increases were also observed in FSH and LH concentrations (P<0.01). PRL levels remained unchanged and E2 did not significantly differ when baseline and 12 weeks levels were compared. Erectile function improved in all responsive patients.
Conclusion: Clomiphene restored normal testosterone levels in most male patients with prolactinomas and persistent hypogonadism under CAB therapy. Recovery of gonadal function by clomiphene was independent of PRL levels.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more