Cabergoline (CAB) was demonstrated to be effective in normalizing cortisol secretion in a subset of patients with Cushings disease (CD). The aim of the study was to evaluate the impact of chronic treatment with CAB on clinical, metabolic and hormonal parameters in CD patients. Twenty-six patients with CD (11 males, 15 females, 1272 years) entered the study. Patients were divided into two groups, responders and non responders, according to the achievement or not of normalization of urinary cortisol (UC) levels. The evaluation of clinical, metabolic and hormonal parameters were performed before and after 6 months treatment with CAB, administered at the dose of 19 mg weekly. The clinical parameters included weight, BMI, waist, systolic and diastolic blood pressure, Back Depression Inventory-II, International Index of Erectional Function (IIEF) and Female Sexual Function Index (FSFI) scores, the metabolic parameters included serum glucose, triglycerides, cholesterol levels, whereas hormonal parameters included plasma ACTH and serum cortisol, androstenedione, DHEAS, renin and aldosterone levels. After 6 months of treatment, 15 patients were responsive (UC decrease=63.2%) whereas 11 patients were not responsive (UC decrease=44.3%). In responsive patients, a significant decrease of plasma ACTH and serum cortisol, systolic and diastolic blood pressure, serum glucose, androstenedione, DHEAS, renin and aldosterone (P<0.05) and a significant increase of IIEF and FSFI (P<0.05) was found. Conversely, in non responsive patients, a significant decrease of plasma ACTH, serum cortisol and androstenedione as well as blood pressure levels (P<0.05) was found, whereas weight and waist significant increased (P<0.05). In conclusion, long-term CAB treatment is able to ameliorate blood pressure, metabolic and hormonal parameters as well as sexual function in responsive patients, but is also able to improve blood pressure and decrease androgen levels in non responsive patients. These results demonstrated that long-term CAB treatment has a relevant impact of the clinical syndrome and complications of patients with CD.
30 Apr - 04 May 2011
European Society of Endocrinology