Abstract
Objective
This study aimed to elucidate the efficacy (as per current biochemical criteria) of cabergoline monotherapy or as addition to long-acting somatostatin receptor ligand (SRL) in patients with acromegaly and no previous pituitary radiotherapy.
Design
Multi-centre, retrospective, cohort study (four UK pituitary centres: Birmingham, Bristol, Leicester, and Oxford).
Methods
Clinical, laboratory, and imaging data were analysed.
Results
Sixty-nine patients on cabergoline monotherapy were included (median insulin-like growth factor 1 [IGF-1] × upper limit of normal [ULN] pre-cabergoline 2.13 [1.02-8.54], median treatment duration 23 months, and median latest weekly dose 3 mg); 31.9% achieved normal IGF-1 (25% growth hormone [GH]-secreting and 60% GH+prolactin co-secreting tumours); median weekly cabergoline dose was similar between responders and non-responders. Insulin-like growth factor 1 normalization was related with GH+prolactin co-secreting adenoma (B 1.50, P = .02) and lower pre-cabergoline IGF-1 × ULN levels (B −0.70, P = .02). Both normal IGF-1 and GH < 1 mcg/L were detected in 12.9% of cases and tumour shrinkage in 29.4% of GH-secreting adenomas.
Twenty-six patients on SRL + cabergoline were included (median IGF-1 × ULN pre-cabergoline 1.7 [1.03-2.92], median treatment duration 36 months, and median latest weekly dose 2.5 mg); 23.1% achieved normal IGF-1 (15.8% GH-secreting and 33.3% GHprolactin co-secreting tumours). Normal IGF-1 and GH < 1 mcg/L were detected in 17.4%.
Conclusions
In non-irradiated patients, cabergoline normalizes IGF-1 in around one-third and achieves both IGF-1 and GH targets in approximately one out of ten cases. SRL + cabergoline is less efficient than previously reported possibly due to differences in study methodology and impact of confounding factors.
This study aimed to elucidate the efficacy (as per current biochemical criteria) of cabergoline monotherapy or as addition to long-acting somatostatin receptor ligand (SRL) in patients with acromegaly and no previous pituitary radiotherapy.
Design
Multi-centre, retrospective, cohort study (four UK pituitary centres: Birmingham, Bristol, Leicester, and Oxford).
Methods
Clinical, laboratory, and imaging data were analysed.
Results
Sixty-nine patients on cabergoline monotherapy were included (median insulin-like growth factor 1 [IGF-1] × upper limit of normal [ULN] pre-cabergoline 2.13 [1.02-8.54], median treatment duration 23 months, and median latest weekly dose 3 mg); 31.9% achieved normal IGF-1 (25% growth hormone [GH]-secreting and 60% GH+prolactin co-secreting tumours); median weekly cabergoline dose was similar between responders and non-responders. Insulin-like growth factor 1 normalization was related with GH+prolactin co-secreting adenoma (B 1.50, P = .02) and lower pre-cabergoline IGF-1 × ULN levels (B −0.70, P = .02). Both normal IGF-1 and GH < 1 mcg/L were detected in 12.9% of cases and tumour shrinkage in 29.4% of GH-secreting adenomas.
Twenty-six patients on SRL + cabergoline were included (median IGF-1 × ULN pre-cabergoline 1.7 [1.03-2.92], median treatment duration 36 months, and median latest weekly dose 2.5 mg); 23.1% achieved normal IGF-1 (15.8% GH-secreting and 33.3% GHprolactin co-secreting tumours). Normal IGF-1 and GH < 1 mcg/L were detected in 17.4%.
Conclusions
In non-irradiated patients, cabergoline normalizes IGF-1 in around one-third and achieves both IGF-1 and GH targets in approximately one out of ten cases. SRL + cabergoline is less efficient than previously reported possibly due to differences in study methodology and impact of confounding factors.
| Original language | English |
|---|---|
| Article number | lvae003 |
| Pages (from-to) | 113–120 |
| Number of pages | 8 |
| Journal | European Journal of Endocrinology |
| Volume | 190 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 17 Jan 2024 |
Bibliographical note
SU was supported by a grant from the Swiss National Science Foundation (SNSF) (P2BSP3_191745).Keywords
- cabergoline
- dopamine agonist
- acromegaly
- non-irradiated patients