| Abstract | BACKGROUND: In the last decade, the treatment of macroprolactinomas has been significantly improved by the introduction in the clinical practice of new drugs with dopamine-agonist properties. In particular, the availability of different forms of bromocriptine (BRC) with long duration of action and slow absorption, suitable for injectable (BRC-LAR) or oral (BRC-SRO) administration, has allowed one to obtain a more constant bromocriptinemia than with standard BRC, thus reducing adverse reactions. Moreover, a selective action on dopamine D2 receptors has been achieved using a new non-ergot derivative: the quinagolide (CV 205-502). The aim of this study was to evaluate the effects of BRC-LAR, BRC-SRO and CV 205-502 in 34 patients with macroprolactinoma. PROTOCOL OF THE STUDY: BRC-LAR was given at the monthly dose of 50-100 mg for 6-24 months to 8 patients whose PRL levels were 150-700 micrograms/l. BRC-SRO was given at the daily dose of 5-20 mg for 1-24 months to 10 patients whose PRL levels were 120-900 micrograms/l. CV 205-502 was given at the daily dose of 0.075-0.6 mg for 6-12 months to 16 patients whose PRL levels were 250-2,050 micrograms/l. CT and/or MRI scans were performed before and during treatment to evaluate tumor shrinkage. Data are presented as Mean +/- SD. RESULTS. Serum PRL levels normalized in 8/8 with BRC-LAR, 7/10 with BRC-SRO and 12/16 patients with CV 205-502. A significant shrinkage of tumor mass was obtained in 7/8 with BRC-LAR, 9/10 with BRC-SRO and 16/16 patients with CV 205-502, with consequent improvement of visual-field defects. Overall, the drugs were rather well tolerated: no patient stopped BRC-LAR or BRC-SRO and only 2 stopped CV 205-502. In particular, nausea, vomiting, headache, hypotension that disappeared spontaneously were observed in 5/8 with BRC-LAR, 4/10 with BRC-SRO and 4/16 with CV 205-502. CONCLUSIONS: The medical approach with long-acting BRC preparations and CV 205-502 which selectively binds D2 receptors allows one to obtain rapid normalization of PRL levels and shrinkage of macroprolactinomas in a large series of patients. These drugs are rather well tolerated also by patients proven to be untolerant to standard BRC. |
| Authors | A Colao, B Merola, F Sarnacchiaro, A Di Sarno, M L Landi, P Marzullo, G Cerbone, D Ferone, G Lombardi
(Affiliation: Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, Naples, Italy.)
|
| Journal | Hormone research
(Horm Res)
Vol. 44
Issue 5
Pg. 222-8
( 1995)
ISSN: 0301-0163 SWITZERLAND |
| PMID | 8582715
(Publication Type: Clinical Trial, Comparative Study, Journal Article)
|
| Chemical References |
- Aminoquinolines
- Dopamine Agonists
- Reagent Kits, Diagnostic
- Bromocriptine
- quinagolide
- Prolactin
|
| Topics |
- Administration, Oral
- Adolescent
- Adult
- Aminoquinolines
(administration & dosage, adverse effects, therapeutic use)
- Bromocriptine
(administration & dosage, adverse effects, therapeutic use)
- Dopamine Agonists
(administration & dosage, adverse effects, therapeutic use)
- Female
- Humans
- Injections, Intravenous
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Pituitary Neoplasms
(drug therapy, pathology, radiography)
- Prolactin
(blood)
- Prolactinoma
(drug therapy, pathology, radiography)
- Radioimmunoassay
- Reagent Kits, Diagnostic
- Tomography, X-Ray Computed
|
