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Pituitary. 2017 Feb;20(1):121-128. doi: 10.1007/s11102-016-0782-6.

Cabergoline in acromegaly.

Kuhn E1,2,3,4, Chanson P5,6,7,8.

Author information

1
Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre Service d'Endocrinologie et des Maladies de la Reproduction, 78 rue du Général Leclerc, 94275, Le Kremlin-Bicêtre, France.
2
Faculté de Médecine Paris-Sud, Université Paris-Sud, Orsay, France.
3
Unité Mixte de Recherche-S1185, 94276, Le Kremlin Bicêtre, France.
4
Institut National de la Santé et de la Recherche Médicale (INSERM) U1185, 94276, Le Kremlin Bicêtre, France.
5
Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre Service d'Endocrinologie et des Maladies de la Reproduction, 78 rue du Général Leclerc, 94275, Le Kremlin-Bicêtre, France. philippe.chanson@bct.aphp.fr.
6
Faculté de Médecine Paris-Sud, Université Paris-Sud, Orsay, France. philippe.chanson@bct.aphp.fr.
7
Unité Mixte de Recherche-S1185, 94276, Le Kremlin Bicêtre, France. philippe.chanson@bct.aphp.fr.
8
Institut National de la Santé et de la Recherche Médicale (INSERM) U1185, 94276, Le Kremlin Bicêtre, France. philippe.chanson@bct.aphp.fr.

Abstract

Acromegaly, a rare disease due to growth hormone (GH) hypersecretion by a pituitary adenoma, is associated with severe comorbidity and premature death if not adequately treated. The usual first-line treatment is surgery. Various drugs, including somatostatin receptor ligands, dopamine agonists and GH receptor antagonists, are now available for use if surgery fails to suppress GH/IGF-I hypersecretion. Cabergoline, now the preferred dopamine agonist for treating hyperprolactinemia, is also used off-label for treating acromegaly. Cabergoline monotherapy is reported to normalize IGF-I levels in more than one-third of patients with acromegaly. When a somatostatin receptor ligand proves ineffective, cabergoline add-on therapy normalizes the IGF-I level in 40-50% of patients. Finally, when combined with the GH receptor antagonist pegvisomant in patients with mild uncontrolled disease, cabergoline helps to achieve normal IGF-I levels while avoiding the need for high-dose pegvisomant. Cabergoline is also inexpensive and well tolerated; in particular, it does not appear to promote heart valve disease.

KEYWORDS:

Acromegaly; Cabergoline; Pegvisomant; Pituitary adenoma; Somatostatin analogues

PMID:
28025719
DOI:
10.1007/s11102-016-0782-6
[Indexed for MEDLINE]

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