| Recurrence of hyperprolactinemia after withdrawal of long-term cabergoline therapy. | |
| | |
MedLine Citation:
|
PMID: 19336508 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
CONTEXT: Recurrence of hyperprolactinemia after cabergoline withdrawal ranges widely from 36 to 80%. The Pituitary Society recommends withdrawal of cabergoline in selected patients. OBJECTIVE: Our aim was to evaluate recurrence of hyperprolactinemia in patients meeting The Pituitary Society guidelines. DESIGN: Patients were followed from the date of discontinuation to either relapse of hyperprolactinemia or the day of last prolactin test. SETTING: We conducted the study at an academic medical center. PATIENTS: Forty-six patients meeting Pituitary Society criteria (normoprolactinemic and with tumor volume reduction after 2 or more years of treatment) participated in the study. INTERVENTIONS: After withdrawal, if prolactin returned above reference range, another measurement was obtained within 1 month, symptoms were assessed by questionnaire, and magnetic resonance imaging was performed. MAIN OUTCOME MEASURES: We measured risk of and time to recurrence estimates as well as clinical predictors of recurrence. RESULTS: Mean age of patients was 50 +/- 13 yr, and 70% were women. Thirty-one patients had microprolactinomas, 11 had macroprolactinomas, and four had nontumoral hyperprolactinemia. The overall recurrence was 54%, and the estimated risk of recurrence by 18 months was 63%. The median time to recurrence was 3 months (range, 1-18 months), with 91% of recurrences occurring within 1 yr after discontinuation. Size of tumor remnant prior to withdrawal predicted recurrence [18% increase in risk for each millimeter (95% confidence interval, 3-35; P = 0.017)]. None of the tumors enlarged in the patients experiencing recurrence, and 28% had symptoms of hypogonadism. CONCLUSIONS: Cabergoline withdrawal is practical and safe in a subset of patients as defined by The Pituitary Society guidelines; however, the average risk of long-term recurrence in our study was over 60%. Close follow-up remains important, especially within the first year. |
| | |
Authors:
|
J Kharlip; R Salvatori; G Yenokyan; G S Wand |
Related Documents
:
|
20080848 - Delayed remission after transsphenoidal surgery in patients with cushing's disease. 2142928 - Pubertal development, growth and final height in girls with sexual precocity after ther... 9932878 - Transsphenoidal microsurgical therapy of prolactinomas: initial outcomes and long-term ... 3499448 - The corticotropin-releasing hormone test in the postoperative evaluation of patients wi... 11196368 - Lateral epicondylalgia: treatment by manipulation under anaesthetic and steroid injecti... 21733358 - Comparison between 0.08% ropivacaine and 0.06% levobupivacaine for epidural analgesia d... |
Publication Detail:
|
Type: Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural Date: 2009-03-31 |
Journal Detail:
|
Title: The Journal of clinical endocrinology and metabolism Volume: 94 ISSN: 1945-7197 ISO Abbreviation: J. Clin. Endocrinol. Metab. Publication Date: 2009 Jul |
Date Detail:
|
Created Date: 2009-07-08 Completed Date: 2009-08-06 Revised Date: 2010-09-22 |
Medline Journal Info:
|
Nlm Unique ID: 0375362 Medline TA: J Clin Endocrinol Metab Country: United States |
Other Details:
|
Languages: eng Pagination: 2428-36 Citation Subset: AIM; IM |
Affiliation:
|
Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland 21201, USA. jkharlip@gmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Antineoplastic Agents / adverse effects, therapeutic use Ergolines / adverse effects, therapeutic use* Female Humans Hyperprolactinemia / diagnosis, drug therapy*, epidemiology, etiology Male Middle Aged Pituitary Neoplasms / complications, drug therapy, pathology Pregnancy Pregnancy Complications, Neoplastic / drug therapy Prognosis Prolactinoma / complications, drug therapy, pathology Recurrence Retrospective Studies Time Factors Withholding Treatment* Young Adult |
| Grant Support | |
ID/Acronym/Agency:
|
T32 DK062707/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Antineoplastic Agents; 0/Ergolines; 81409-90-7/cabergoline |
| Comments/Corrections | |
Comment In:
|
J Clin Endocrinol Metab. 2009 Jul;94(7):2247-9
[PMID:
19584197
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Identification of novel variants in the hepatocyte nuclear factor-1alpha gene in South Indian patien...
Next Document: Treatment and Prevention of Vitamin D Insufficiency in Cystic Fibrosis Patients: Comparative Efficac...