Details

Autor(en) / Beteiligte

• Colao, Annamaria
• Ferone, Diego
• Marzullo, Paolo
• Di Sarno, Antonella
• Cerbone, Gaetana
• Sarnacchiaro, Francesca
• Cirillo, Sossio
• Merola, Bartolomeo
• Lombardi, Gaetano

Titel

Effect of Different Dopaminergic Agents in the Treatment of Acromegaly

Ist Teil von

• The journal of clinical endocrinology and metabolism, 1997-02, Vol.82 (2), p.518-523

Ort / Verlag

Bethesda, MD: Endocrine Society

Erscheinungsjahr

1997

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Medical treatment of acromegaly with dopamine agonists possesses 2 main advantages: the oral administration and the low costs. In this study, we reported on the results of chronic treatments with quinagolide (CV 205–502), cabergoline (CAB) and long-acting depot preparation of bromocriptine (BRC-LAR) in 34 acromegalics. Patients were divided into three groups on the basis of different treatment: CV 205–502 given to 16 patients at the dose of 0.3–0.6 mg/day for 6 months; CAB given to 11 patients at the dose of 1.0–2.0 mg weekly for 6 months; and BRC-LAR injected into 7 patients at the dose of 100 mg/month for 6–12 months. Basal and oral glucose tolerance test-stimulated serum GH levels, basal and TRH-stimulated PRL levels, plasma insulin-like growth factor I (IGF-I) levels, computed tomography scan, and/or magnetic resonance imaging were assessed before and quarterly during treatments. The chronic administration of CV 205–502, CAB, and BRC-LAR caused a significant decrease of circulating GH, IGF-I, and PRL levels (P < 0.005). Normalization of circulating GH and IGF-I levels was obtained in 7 of 16 (43.8%) patients treated with CV 205–502. Serum GH response to oral glucose tolerance test (oGTT) significantly improved (P < 0.005), and PRL levels were significantly suppressed during treatments. No correlation was found between basal and TRH-stimulated PRL levels and GH suppression during different therapies. Immunohistochemical staining revealed 19 GH-positive and 10 GH+PRL-positive adenomas. A significant association was found between GH/PRL staining and responsiveness to chronic treatments (χ2 = 7.985, P < 0.005). Three patients had significant adenoma shrinkage. Slight nausea and hypotension, which spontaneously disappeared within therapy progression, were referred by 5/16 patients during CV 205–502 and 2/7 during BRC-LAR. The results of this study indicate that CAB and BRC-LAR cannot be considered as useful medical approaches for acromegalics, whereas CV 205–502 normalized circulating GH and IGF-I levels in 47.8% of patients.