UI - 97382038
AU - Tabarin A; Catargi B
TI - [Treatment of macroprolactinomas with quinagolide (Norprolac)]
SO - Ann Endocrinol (Paris) 1997;58(2):87-94
AD - Departement d'Endocrinologie-Diabetologie, CHU de Bordeaux, Hopital du
Haut-Leveque, Pessac.
AB - Quinagolide is a non-ergot dopaminergic agonist recently available on
the French market. The endocrine and tumoral efficacy as well as the
safety and tolerability of quinagolide in the treatment of macroprol-
actinomas are reviewed. In this situation, plasma prolactin levels
are normalized in about 60% of patients and in about one third of
those who are resistant to bromocriptine. A significant decrease in
pituitary tumor size is demonstrated by radiographic studies in 58 to
69% of patients. About one third of patients show more than 50% tumor
shrinkage. The tolerability of quinagolide is satisfactory in most
cases and clearly better than that of bromocriptine. Thus, quinagoli-
de is a useful tool in the treatment of macroprolactinomas. (30 Refs)
NLM CIT. ID: 92228958
TITLE: Endocrine function, psychiatric and clinical consequences in patients
with macroprolactinomas after long-term treatment with the new non-
ergot dopamine agonist CV205-502.
AUTHORS: Barnett PS; Palazidou E; Miell JP; Coskeran PB
Butler J; Dawson JM; Maccabe J; McGregor AM
AUTHOR AFFILIATION:
Department of Medicine, King's College School of Medicine and
Dentistry, London.
PUBLICATION TYPES:
JOURNAL ARTICLE
LANGUAGES:
Eng
REGISTRY NUMBERS:
0 (Aminoquinolines)
0 (Dopamine Agents)
9002-62-4 (Prolactin)
97805-50-0 (CV 205-502)
ABSTRACT:
Although bromocriptine is the mainstay of treatment of
macroprolactinomas, its therapeutic usefulness may be limited by poor
tolerance, lack of consistent reduction in serum prolactin levels and
tumour size, and the necessity for multiple dosing. Consequently new
dopamine agonists have been developed, including the long acting non-
ergot agonist CV205-502 which has been shown to date to be
consistently effective in reducing serum PRL levels and causing
tumour shrinkage. Twelve patients were treated for periods of up to
24 months with CV205- 502 in doses ranging from 0.075 mg to 1.65 mg
once daily. Clinical and psychiatric assessments, biochemical
parameters, tumour size determination, and anterior pituitary
function tests were performed regularly. Tumour shrinkage was noted
in all patients, and varied from 11 per cent reduction to complete
disappearance of tumour. Prolactin levels became normal in seven
patients and were reduced by more than 90 per cent in the remaining
five. Normal menstruation resumed in six of the eight women, one of
whom conceived after one year of therapy; libido returned in all
patients. Psychiatric complications occurred in three patients
necessitating withdrawal of therapy in one. Significant weight loss
was noted in 11 of 12 patients. Triglyceride concentrations fell from
1.5 +/- 0.1 to 1.0 +/- 0.1 mmol/l at 12 months (p = 0.006), and
cholesterol fell from 6.3 +/- 0.4 to 5.3 +/- 0.3 mmol/l (p = 0.04).
The mean TSH response 20 min following TRH injection fell from 14.3
+/- 2.9 to 8.7 +/- 1.3 mU/l at 2 months (p = 0.027). There was a
significant increase in the peak growth hormone response to the
insulin stress test from basal median (25th-75th centiles) values of
15 (4.4- 25.5) mU/l to 24.5 (9-37) mU/l at 2 months (p less than
0.01) and 31 (19.3-63.5) at 12 months (p less than 0.005). CV205-502
is highly effective in the medical management of patients with
macroprolactinomas, reducing prolactin levels and tumour size and
restoring normal anterior pituitary function. It is, however,
associated with the important side effects of weight loss and
psychiatric complications which should be drawn to the attention of
clinicians.
MAIN MESH HEADINGS:
Aminoquinolines/*therapeutic use
Dopamine Agents/*therapeutic use
Pituitary Gland, Anterior/*physiopathology
Pituitary Neoplasms/*drug therapy
Prolactinoma/*drug therapy
ADDITIONAL MESH HEADINGS:
Adult
Aminoquinolines/adverse effects
Dopamine Agents/adverse effects
Female
Human
Male
Mental Disorders/chemically induced
Middle Age
Pituitary Neoplasms/pathology
Pituitary Neoplasms/physiopathology
Prolactin/blood
Prolactinoma/pathology
Prolactinoma/physiopathology
Support, Non-U.S. Gov't
Weight Loss/drug effects
NLM PUBMED CIT. ID:
1687293
SOURCE: Q J Med 1991 Nov;81(295):891-906
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