Aim: The aim of the study was to investigate the clinical and hormonal effectiveness of different modes of suppressive cabergoline (CAB) therapy during 12 months in patients with prolactinoma.
Subjects and methods: It was examined and underwent a 12 month course of treatment by selective dopamine agonist CAB in 61 patients with prolactinoma (PROL) (9 male/ 52 female) aged 1666 years. There were 40 women with microPROL, 12 with macro&giant PROL; among men it were 2 with microadenoma and 7 with macroadenoma. The total duration of the disease ranged from 1 to 60 months, average (12.3±10.1) months. PROL was verified using MRI and PRL blood levels (ng/mL). Applied two modes of therapy: 1 the mode of gradual increase of a CAB dose, since 0.5 mg a week with the subsequent control of the PRL blood level in each 4 weeks and titration CAB dose if necessary (increase in a week dose by 0.25 0.5 mg); group 2 the mode of high starting doses from calculation: the quantity of tablets CAB (0.5 mg) corresponded to frequency rate of increase of the PRL blood level in relation to the upper limit of age norm, but no more than 4 mg (8 tablets) a week.
Results: Proposed an integrated system that allows estimating the effectiveness of clinical and hormonal parameters during CAB suppressive therapy in patients with PROL. It is enables in all stages to carry out the treatment, to assess the possible risks from using the large doses of medication and to optimize the selection of an adequate dose. The optimal mode of CAB therapy in patients aged 40 yrs and older with microPROL is the regime of gradually increasing the dose, the positive clinical and hormonal effect which is observed in 80% of patients 3 months after start of the treatment. Assigning mode high starting doses of CAB in young and middle-aged patients with macro- and giant PROL allows for a shorter time (1 month), to achieve reliable positive dynamics of neurological, somatic and hormonal status compared with the group of patients receiving therapy in the mode of gradually increasing CAB doses.
Keywords: prolactinoma, cabergoline, treatment
18 - 21 May 2019
European Society of Endocrinology