- |||||||||| cabergoline / Generic mfg., Somavert (pegvisomant) / Pfizer, Signifor LAR (pasireotide) / Novartis
[VIRTUAL] Pituitary Magnetic Resonance Imaging in the Postoperative Follow-Up of Patients with Acromegaly, Less Is More! () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_1488;
Current guidelines for MRI surveillance recommend 12 week post-operative (postop) imaging for all pts and yearly if on pegvisomant (PEG)...55 pts were on PIT-directed therapy (50 on somatostatin receptor ligands (SRL) alone, 1 on cabergoline (Cab) alone, 4 on SRL/Cab), 12 on PEG > 1 year (9 on PEG alone.) 11/83 (13.25%) had tumor growth at median 3.5 years (range 1-11)...Conversely, pts with residual adenoma not on medical therapy should be closely monitored biochemically and by serial MRIs. Further studies are needed to identify appropriate imaging interval for pts on medications and based on characteristics of aggression (such as sparsely granulated, large residual tumors, lack of biochemical control despite medications).
- |||||||||| ropinirole IR / Generic mfg., bromocriptine / Generic mfg.
[VIRTUAL] Treatment of Hyperprolactinemia with Ropinirole: An Open-Label Dose Escalation Study () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_1463;
Conclusion These data provide support for the efficacy of ROP in the treatment of hyperprolactinemia in patients with microprolactinomas and idiopathic hyperprolactinemia. While further study is needed, ROP treatment for hyperprolactinemia could be considered in patients with ergot DA intolerance or significant cardiac valve disease.
- |||||||||| [VIRTUAL] Histologically Proven Lymphocytic Hypophysitis with Marked Improvement on Glucocorticoid Therapy () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_1424;
Cabergoline was initiated for a presumed prolactinoma...She was also found to have Hashimoto’s thyroiditis (FT4 0.7 ng/dL, TSH 8.2 uU/mL with positive TPO antibodies) and was started on levothyroxine...Prednisone was gradually tapered to 5mg/day, and she was subsequently transitioned to maintenance hydrocortisone for central adrenal insufficiency...High dose glucocorticoid therapy, to which our patient responded to dramatically, has been shown to be beneficial in reducing mass effect. Optimal treatment involves surgical resection of the pituitary mass to decompress surrounding structures.3
- |||||||||| Lantus (insulin glargine) / Sanofi
[VIRTUAL] Pituitary Hyperplasia Due to Uncontrolled Primary Hypothyroidism: Case Series and Literature Review () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_1394;
She was treated with insulin glargine 20U qd, and levothyroxine 200 mcg/day...Cabergoline was started without any clinical improvement...She was previously treated with hydrocortisone 25mg/day, fludrocortisone 0.1mg/day, and levothyroxine 200mcg/day... We presented three young women, with autoimmune hypothyroidism, who developed pituitary hyperplasia and responded to proper hormonal replacement normalizing pituitary size.
- |||||||||| cabergoline / Generic mfg.
[VIRTUAL] Too Big to Be True, Too Young to Stroke! () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_1389;
Giant prolactinomas are uncommon and can present with compressive symptoms, that can be mistaken as stroke. Treatment with anticoagulation may cause hemorrhage and apoplexy with worsening of symptoms.1,2 There is limited data available regarding first line therapy for giant prolactinomas with 2 case reports where giant prolactinomas have been treated effectively with cabergoline.3,4 It is important to recognize the cause of such symptoms, and treated where possible with effective medical therapy to prevent morbidity.
- |||||||||| cabergoline / Generic mfg., Tirosint (levothyroxine) / IBSA Institute Biochemical SA
[VIRTUAL] Pituitary Hyperplasia Due to Severe Primary Hypothyroidism: An Uncommon Manifestation of a Common Disease () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_1381;
This was presumed to be secondary to a prolactinoma and cabergoline was started by the referring provider...On further questioning, the patient ran out of levothyroxine replacement 6 months ago and had been generally non-adherent to therapy for years due to nausea...Long-term biochemical and radiological monitoring is therefore recommended until resolution. This case highlights the physiologic responses manifested in severe primary hypothyroidism and the fact that these changes improve with adequate replacement.
- |||||||||| temozolomide / Generic mfg.
[VIRTUAL] Significant Response to Temozolomide in Two Aggressively Growing Pituitary Adenomas () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_1376;
This promising clinical course after exposure to temozolomide with early, significant tumor shrinkage in two heavily pretreated patients with aggressive pituitary adenomas indicates that this therapy can be considered also in older patients and may yield astonishing results. Although temozolomide is increasingly becoming a therapeutic option for those patients whose pituitary tumors are refractory to standard therapies, further research and observance over time of temozolomide therapy in aggressive pituitary adenomas and carcinomas is indicated.
- |||||||||| cabergoline / Generic mfg.
[VIRTUAL] The Unique Etiology and Management of a Third Cranial Nerve Palsy () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_1288;
About 90% of cases resolve by one year after pituitary surgery. Although our patient had a tumor that was slightly larger than 1 cm, she did not need hormonal replacement, did not have hemorrhage/necrosis, and her symptoms resolved with a dopamine agonist.
- |||||||||| cabergoline / Generic mfg., bromocriptine / Generic mfg.
[VIRTUAL] Vaginal Cabergoline: A Simple Solution to a Challenging Problem () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_1280;
Interestingly, tolerance to DA can be improved by administering the drug intravaginally, which can have similar efficacy to the oral route and a more favorable side-effect profile. However, only a few studies assessed the effectiveness and tolerance of vaginal DAs in hyperprolactinemic patients intolerant to oral medications, little evidence supports the use of intravaginal DA to improve drug tolerance, and further studies are necessary to determine the safety and efficacy of vaginal cabergoline.
- |||||||||| cabergoline / Generic mfg., bromocriptine / Generic mfg.
[VIRTUAL] Priapism Secondary to Cabergoline () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_1273;
The time between drug use and occurrence, absence of other offending medications or precipitating factors and no further priapism episodes once treatment was discontinued suggests a priapism as a rarely reported side effect of Cabergoline. (1)
- |||||||||| bromocriptine / Generic mfg.
[VIRTUAL] Resolution of a Cystic Macroprolactinoma with Dopamine Agonist Therapy () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_1264;
Median time to documented cyst reduction was approximately six months, and there was no difference in degree of cyst reduction for patients treated with bromocriptine or cabergoline. The response of cystic prolactinomas to DA is similar to solid prolactinomas, and DA are reasonable initial treatment for cystic macroprolactinomas without clear indications for surgery.
- |||||||||| medroxyprogesterone injection / Generic mfg.
[VIRTUAL] Surprising Transformation of a Microprolactinoma to a Macroprolactinoma () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_1262;
Previous studies of untreated microprolactinomas have shown that they undergo only subtle to minimal growth over 3 to 6 years and none transformed to a macroprolactinoma despite significant rises in PRL levels. In this clinical case, given the 6 intervening years that had elapsed in between MRIs, we cannot determine whether this represented moderate, progressive growth during that period after the discontinuation of DA therapy or whether the tumor had grown during pregnancy with its known stimulatory effects from hyperestrogenemia.
- |||||||||| cabergoline / Generic mfg.
Clinical, Journal: Clinical Features, Therapeutic Trends, and Outcome of Giant Prolactinomas: A Single-Center Experience Over a 12-Year Period. (Pubmed Central) - Jun 19, 2020
The aim of this study was to report the largest long-term single-center study of giant prolactinomas to analyze their clinical features; define epidemiological characteristics, comorbidities, complications, treatment outcomes; and to demonstrate our experience with long-term cabergoline (CAB) treatment of these giant tumors...Findings reinforce results from our previous study that CAB provides dramatic clinical improvements with an excellent safety profile. The CAB should, therefore, be considered as the primary therapy for giant prolactinomas.
- |||||||||| sirolimus / Generic mfg.
Journal: DEPTOR inhibits cell proliferation and confers sensitivity to dopamine agonist in pituitary adenoma. (Pubmed Central) - Jun 12, 2020
DEP domain-containing mechanistic target of rapamycin (mTOR)-interacting protein (DEPTOR) is an important modulator of mTOR, a highly conserved kinase whose hyperactivation is critically involved in a variety of human tumors...Consistently, overexpression of DEPTOR inhibited pituitary tumor GH3 and MMQ cells proliferation in vitro and in vivo, and sensitized GH3 and MMQ cells to cabergoline (CAB), a dopamine agonist (DA)...Furthermore, DEPTOR enhanced autophagy-dependent cell death to confer cells sensitivity to CAB. Taken together, our results suggest that DEPTOR may be a potential target for the treatment of PAs.
- |||||||||| bromocriptine / Generic mfg., blonanserin / Generic mfg.
Retrospective data, Review, Journal: Pharmacological treatment strategies for lowering prolactin in people with a psychotic disorder and hyperprolactinaemia: A systematic review and meta-analysis. (Pubmed Central) - Jun 9, 2020
We aimed to examine the evidence from open-label studies and randomized clinical trials (RCTs) that studied four prolactin-lowering therapeutic strategies in people with psychotic disorders and hyperprolactinaemia: 1) switching to prolactin-sparing antipsychotics; 2) adding aripiprazole; 3) adding dopamine agonists; and 4) adding metformin...Nine studies explored switching antipsychotic treatment to aripiprazole (n = 4), olanzapine (n = 1), quetiapine (n = 2), paliperidone palmitate (n = 1) or blonanserin (n = 1)...Six studies explored the addition of cabergoline (n = 3), bromocriptine (n = 2) or terguride (n = 1)...The three placebo-controlled RCTs for aripiprazole addition showed similar withdrawal rates for aripiprazole (10.1%) and placebo (11.5%), without significant differences in the meta-analysis. Our study suggests that, in terms of levels of evidence, adding aripiprazole is the first option to be considered for lowering prolactin concentrations in patients with schizophrenia and hyperprolactinaemia.
- |||||||||| cabergoline / Generic mfg.
Biomarker, Journal: Exosome-transmitted lncRNA H19 inhibits the growth of pituitary adenoma. (Pubmed Central) - Jun 8, 2020
Exosomal H19 inhibits the growth of distal pituitary tumors through inhibiting 4E-BP1 phosphorylation. Plasma exosomal H19 may serve as an important biomarker for predicting medical response of patients with prolactinomas.
- |||||||||| cabergoline / Generic mfg.
Clinical, Journal: Clinical and genetic studies of a three-member familial isolated pituitary adenoma with homogeneous prolactinomas (Pubmed Central) - Jun 8, 2020
The patients presented with macroadenomas at the time of diagnosis, non-invasive tumors and good biological response to cabergoline treatment (maximum dose of 1.5 mg/weekly)...The genetic analysis of the aryl hydrocarbon receptor interacting protein (AIP) was normal. As nearly 80% of patients with FIPA do not have a mutation in the AIP gene, future studies in these families are required to identify other affected genes involved in their physiopathology.
- |||||||||| aripiprazole / Generic mfg.
Review, Journal: Targeting Hormones for Improving Cognition in Major Mood Disorders and Schizophrenia: Thyroid Hormones and Prolactin. (Pubmed Central) - Jun 4, 2020
In sum, thyroid hormones and prolactin might contribute to the cognitive performance of patients with major mood disorders and psychotic disorders. Thyroid hormones and prolactin-lowering drugs (e.g. cabergoline, aripiprazole) are candidate drugs to be tested in repurposing clinical trials aiming to improve the cognitive abilities of patients with major mood disorder and schizophrenia.
- |||||||||| cabergoline / Generic mfg.
Clinical, Journal: Acidophil stem cell pituitary adenoma: a case report and literature review. (Pubmed Central) - May 31, 2020
To our knowledge, this is the only case report which describes acromegaly developing during cabergoline treatment. This case also highlights the importance of having a correct histopathological diagnosis to determine the behavior of the tumor and decide on further management.
- |||||||||| cabergoline / Generic mfg., temozolomide / Generic mfg.
Clinical, Journal: Clinical management of difficult to treat macroprolactinomas. (Pubmed Central) - May 29, 2020
In case of surgery, a careful analysis of the tumor sample can provide information about its aggressivity potential according to recent criteria. Ultimately, temozolomide can be indicated if the tumor is rapidly growing and/or threatening for the patient.
- |||||||||| cabergoline / Generic mfg., Somavert (pegvisomant) / Pfizer, Signifor LAR (pasireotide) / Novartis
Review, Journal: Octreotide-Resistant Acromegaly: Challenges and Solutions. (Pubmed Central) - May 24, 2020
Furthermore, we discussed the potential molecular mechanisms involved in the variable response to first-generation SRLs. Due to the availability of different medical therapies, the choice for the most appropriate drug can be currently based also on the peculiar clinical characteristics of each patient.
- |||||||||| bromocriptine / Generic mfg.
ANALYSIS OF PREDICTIVE FACTORS FOR REACHING DOPAMINE AGONIST WITHDRAWAL CONDITIONS IN PROLACTINOMAS () - May 24, 2020 - Abstract #AACE2020AACE_269;
108 patients were treated with cabergoline (0.25-2 mg/week), and 11 with bromocriptine (8.75–105 mg/week). Male patients with parasellar tumor invasiveness and low percentage change in prolactin levels upon first follow up are less likely to reach conditions of DA withdrawal, and more likely to require long-term treatment
- |||||||||| Signifor (pasireotide) / Recordati
Trial completion, Trial primary completion date, Combination therapy: Study of the Efficacy and Safety of Pasireotide s.c. +/- Cabergoline in Patients With Cushing's Disease (clinicaltrials.gov) - May 22, 2020
P2, N=68, Completed,
Male patients with parasellar tumor invasiveness and low percentage change in prolactin levels upon first follow up are less likely to reach conditions of DA withdrawal, and more likely to require long-term treatment Terminated --> Completed | Trial primary completion date: Sep 2016 --> Sep 2019
- |||||||||| cabergoline / Generic mfg., bromocriptine / Generic mfg.
Journal: Bromocriptine and cabergoline induce cell death in prolactinoma cells via the ERK/EGR1 and AKT/mTOR pathway respectively. (Pubmed Central) - May 21, 2020
Using gene microarray analysis, we found that BRC induces the apoptosis of prolactinoma cells through the ERK/EGR1 signalling pathway, whereas CAB induces autophagic death by inhibiting the AKT/mTOR signalling pathway. Our study showed the difference in tumour sensitivity and differential mechanisms in BRC- and CAB-treated prolactinoma cells, which provides a theoretical basis for the accurate treatment of prolactinoma.
- |||||||||| cabergoline / Generic mfg.
[VIRTUAL] Prevalence of Clinically Apparent Prolactinomas in the Subfertile Male (WEWCC: 146B) - May 17, 2020 - Abstract #AUA2020AUA_1570;
We found a 350-fold increased prevalence of prolactinoma among our cohort when compared to the general male population. Despite a low absolute prevalence, prolactinoma remains an important source of morbidity and potential etiology for subfertility, and clinicians should continue to include this condition in the differential diagnosis of male subfertility.
- |||||||||| cabergoline / Generic mfg.
Journal: Hyperprolactinemia / Prolactinomas in the post-menopausal period: challenges in diagnosis and management . (Pubmed Central) - May 9, 2020
Reducing doses of cabergoline to the lowest that keeps prolactin levels normal prior to withdrawal is proposed to patients with macroprolactinomas who normalize prolactin after > 5 years of treatment and who do not have cavernous sinus invasion...This is based on: 1) reports that elevated prolactin levels may normalize in some women after menopause, 2) the association between prolactin levels and breast cancer is inconsistent in postmenopausal women, 3) there is no clinical evidence that normalization of prolactin levels in postmenopausal women improved bone mineral density (BMD) or reduced fracture risk and, 4) concerning the metabolic syndrome no data are available on metabolic parameters after suspending treatment with dopamine agonists. For a change in strategy i.e. for the potential benefits from treatment of hyperprolactinemia in the postmenopausal period with dopamine agonists concerning weight loss, improved insulin sensitivity, decreased fracture risk, improved sexuality more evidence is needed..
- |||||||||| bromocriptine / Generic mfg.
Journal: Giant Prolactinomas. (Pubmed Central) - May 9, 2020
Long-term (usually lifetime) therapy with high-dose dopamine agonists (cabergoline or bromocriptine), together with pituitary surgery in some cases and radiotherapy if required, can achieve biochemical remission, tumor control, and clinical improvement in most patients. .
- |||||||||| bromocriptine / Generic mfg.
Review, Journal: Management of dopamine agonist-resistant prolactinoma. (Pubmed Central) - May 9, 2020
However, normal prolactinemia will eventually occur in only one third of patients after many years. Finally, temozolomide may be a therapeutic option in malignant/aggressive prolactinomas. .
- |||||||||| bromocriptine / Generic mfg.
Review, Journal: Dopamine Agonists - from the 1970s up to today. (Pubmed Central) - May 9, 2020
The discovery of dopamine inhibitory effects on prolactin secretion has led to an era of successful dopaminergic therapy for prolactinomas. Herein we provide an overview of the evolution of dopamine agonists and their use in patients with PRL-secreting pituitary tumors, starting from the 1970s up to today, highlighting that normalization of PRL levels, restoration of eugonadism, and reduction of tumor mass can be achieved in the majority of patients by treatment with dopamine agonists.
- |||||||||| Review, Journal: Advances in the medical treatment of Cushing's syndrome. (Pubmed Central) - May 7, 2020
CORT125134 is a new selective glucocorticoid receptor antagonist under investigation. We summarise the drug therapies for various forms of Cushing's syndrome and focus on emerging drugs and drug targets that have the potential for new and effective tailor-made pharmacotherapy for patients with Cushing's syndrome.
- |||||||||| everolimus / Generic mfg.
Journal: Effect of Everolimus in Treatment of Aggressive Prolactin-Secreting Pituitary Adenomas. (Pubmed Central) - May 7, 2020
We describe off-label everolimus treatment of a prolactinoma (PRLoma) refractory to cabergoline, repeat surgical resection, and radiation therapy...In summary, our findings demonstrate that the mTOR pathway is activated in PRLomas and everolimus exhibits anti-proliferative actions in vitro. We suggest that everolimus may be a novel therapeutic option for some aggressive PRL-secreting tumors unresponsive to conventional treatments.
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