Baseline clinical and treatment characteristics of dopamine agonist treated patients in a Dutch national cohort of patients with prolactinoma

Ingrid Zandbergen; Iris Pelsma; Furth Wouter van; Nienke Biermasz

doi:10.1530/endoabs.90.P147

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Endocrine Abstracts (2023) 90 P147 | DOI: 10.1530/endoabs.90.P147

ECE2023 Poster Presentations Pituitary and Neuroendocrinology (123 abstracts)

Baseline clinical and treatment characteristics of dopamine agonist treated patients in a Dutch national cohort of patients with prolactinoma

Ingrid Zandbergen ^1,2 , Iris Pelsma ¹ , Wouter van Furth ² & Nienke Biermasz ¹

Err

Author affiliations

¹Leiden University Medical Center, Deparment of Medicine, Division of Endocrinology, Leiden, Netherlands; ²Leiden University Medical Center, Deparment of Neurosurgery, Leiden, Netherlands

Introduction: Dopamine agonists (DA) are first-line treatment for prolactinomas and effectively control hyperprolactinemia in most patients. However, side effects may negatively impact health-related quality of life; and post-withdrawal remission rates are low, resulting in prolonged DA treatment.

Methods: Dutch multicenter prospective observational cohort study mapping standard care for 316 prolactinoma patients. Baseline clinical characteristics and treatment outcomes of 210 DA treated (DAT) patients are described (mean age 49.4±15.4 years; females n=122, 58.1%). 106 patients were not treated with DA at inclusion.

Results: Current prolactin levels -available for 155 patients- were elevated above the sex specific upper limit of normal in 54 (34.8%) patients, not different between males and females. Imaging data -available for 60 patients- showed 21 (35.0%) microprolactinomas, 23 (38.3%) macroprolactinomas, 1 (1.7%) giant prolactinoma, whereas in 10 (16.7%) patients no adenoma was visible, and 5 (8.3%) had a postoperative remnant. Males had more macroprolactinomas (15 (62.5%) vs 8 (22.2%), P<0.001). Galactorrhea was reported by 15/119 (12.6%) patients (males n=1/50 (2.0%) vs females n=14/69 (20.3%), P=0.004). Hypogonadism was reported by 42/153 (27.5%) patients, and subfertility by 10/118 (8.5%) patients, not different between males and females. DA side effects -measured using the PROCTCAE questionnaire (n=155)- were gastro-intestinal tract symptoms (e.g. diarrhea, constipation, nausea) in 63 (40.6%) patients (males n=14/68 (20.6%) vs females n=49/87 (56.3%) P<0.001). 77 (50.0%) patients reported fatigue (males n=22/68 (32.4%) vs females n=55/86 (64.0%) P<0.001). 41 (26.6%) patients reported concentration loss (not different between males and females).

Conclusions: In this Dutch national cohort of patients with prolactinoma, 210 DA treated patients were identified. We describe baseline clinical characteristics and significant sex differences for most outcomes of interest, which need to be taken in to account when interpreting treatment outcomes of prolactinoma patients.