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mens sana in corpore sano...

endocrinología | metabolismo | nutrición

Cabergoline monotherapy in the long-term treatment of Cushing’s disease

Escrito por Dr. Oscar Domingo Bruno
PDFImprimirCorreo electrónico
23
Oct
2019

Nuestro agradecimiento al Dr. Oscar. D. Bruno por el envío de este valioso material.

Background: Cabergoline is a long-acting dopamine receptor agonist used to treat prolactinomas. Identification of D2 receptors in corticotroph tumors led to clinical trials of cabergoline therapy in limited cases of Nelson’s syndrome, ectopic ACTH-secreting tumors, and recently Cushing’s disease (CD). Objective: To evaluate the long-term efficacy of cabergoline monotherapy in patients with CD. Methods: Retrospective analysis of non-randomized clinical therapy with cabergoline in 30 patients with CD treated in academic centers of Buenos Aires and Montreal. Cabergoline was initiated at 0.5–1.0 mg/week and adjusted up to a maximal dose of 6 mg/week based on urinary free cortisol (UFC) levels. Complete response to cabergoline was defined as a sustained normalization of UFC with at least two normal values measured at 1–3 months interval; partial response was defined as a decrease of UFC to !125% of the upper limit of normal, and treatment failure as UFC R125% of it.

Results: Within 3–6 months, complete response was achieved in 11 patients (36.6%) and partial response in 4 patients (13.3%). After long-term therapy, nine patients (30%) remain with a complete response after a mean of 37 months (range from 12 to 60 months) with a mean dose of 2.1 mg/week of cabergoline. Two patients escaped after 2 and 5 years of complete response, but one patient transiently renormalized UFC after an increase in cabergoline dosage. No long-term response was maintained in four initial partial responders.

Conclusions: Cabergoline monotherapy can provide an effective long-term medical therapy for selected patients with CD, but requires close follow-up for dose adjustments.

 

Cabergoline Cushings

 

Última actualización el 29 de Octubre de 2019
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