Endocrine Abstracts

JOINT77

Introduction: Prolactinomas are the most common pituitary adenomas, leading to an increased secretion of prolactin. The symptoms vary and include symptomatic as well as asymptomatic courses. Symptoms are mainly caused by suppression of the hypothalamic–pituitary–gonadal axis (HPG axis). This causes galactorrhea, infertility, oligo-amenorrhea, impotence and osteoporosis as well as symptoms of mass effect (hypopituitarism, visual loss, optic chiasm compression, headaches). For most patients dopamine agonist therapy with Cabergoline represents the primary and most effective therapy. For individual therapy planning the knowledge of influencing factors and disease progression is essential. Our goal was to examine the time period until HPG axis is normalized, as well as the role of influencing factors.

Patients and methods: We retrospectively analyzed the data of patients who were treated in the specialist center of Amedes experts Hamburg between 2013 to 2023 from diagnosis until remission. From initially 410 patients 66 patients fulfilled all inclusion criteria. Diagnosis of suppressed HPG-axis was made by measuring diminished serum concentrations of LH, FSH, estradiol and testosterone. We measured the time period until those concentrations normalized under Cabergoline-therapy and assessed for a significant correlation between this time period and influencing factors using Spearmans rank correlation coefficient and non- parametric Mann-Whitney-U-Test.

Results: The mean duration until normalization of HPG axis under Cabergoline-therapy was 82 days. Statistical analysis showed significant correlation between this duration and initial prolactin levels as well as gender and age. Thus, patients with higher initial prolactin levels, older patients and males showed longer treatment durations. There was no correlation between the time period and adenoma size, Cabergoline dosage, comedication and accompanying diseases.

Conclusions: The acquired data allows for a more precise estimation of treatment duration and patient counseling. Furthermore, it can be useful in creating long term therapy concepts. Patients with prolonged suppression of HPG-axis could receive early hormonal replacement therapy if needed.