Department of Internal Medicine, University Medical Center Utrecht, Room Number L 00.408, PO Box 85500, 3508 GA Utrecht, The Netherlands.
Eur J Endocrinol. 2010 Apr;162(4):667-75. doi: 10.1530/EJE-09-0989. Epub 2010 Jan 13.
Cabergoline, a dopamine agonist used to treat hyperprolactinemia, is associated with an increased risk of fibrotic adverse reactions, e.g. cardiac valvular fibrosis, pleuropulmonary, and retroperitoneal fibrosis.
This study evaluated the prevalence and risk of fibrotic adverse reactions during cabergoline therapy in hyperprolactinemic and acromegalic patients.
A cross-sectional study was conducted in a University Hospital.
A total of 119 patients with hyperprolactinemia and acromegaly who were on cabergoline therapy participated in the study.
All patients were requested to undergo a cardiac assessment, pulmonary function test, chest X-ray, and blood tests as recommended by the European Medicine Agency. Matched controls were recruited to compare the prevalence of valvular regurgitation. Cardiac valvular fibrosis was evaluated by assessing valvular regurgitation and the mitral valve tenting area (MVTa). The risk of pleuropulmonary fibrosis was assessed by a pulmonary function test, a chest X-ray, and if indicated, by additional imaging studies.
The prevalence of clinically relevant valvular regurgitation was not significantly different between cases (11.3%) and controls (6.1%; P=0.16). The mean MVTa was 1.27+/-0.17 and 1.24+/-0.21 cm(2) respectively (P=0.54). Both valvular regurgitation and the MVTa were not related to the cumulative dose of cabergoline. A significantly decreased pulmonary function required additional imaging in seven patients. In one patient, possible early interstitial fibrotic changes were seen. Lung function impairment was not related to the cumulative cabergoline dose.
Cabergoline, typically dosed for the long-term treatment of hyperprolactinemia or acromegaly, appears not to be associated with an increased risk of fibrotic adverse events.
卡麦角林是一种用于治疗高泌乳素血症的多巴胺激动剂，与纤维性不良反应的风险增加有关，例如心脏瓣膜纤维化、胸膜肺和腹膜后纤维化。
本研究评估了卡麦角林治疗高泌乳素血症和肢端肥大症患者期间纤维性不良反应的发生率和风险。
在一所大学医院进行了一项横断面研究。
共有 119 名接受卡麦角林治疗的高泌乳素血症和肢端肥大症患者参与了这项研究。
所有患者均被要求按照欧洲药品管理局的建议进行心脏评估、肺功能测试、胸部 X 光检查和血液检查。招募匹配的对照组以比较瓣膜反流的发生率。通过评估瓣膜反流和二尖瓣幕面积（MVTa）来评估心脏瓣膜纤维化。通过肺功能测试、胸部 X 光检查以及必要时进行额外的影像学研究来评估胸膜肺纤维化的风险。
病例组（11.3%）和对照组（6.1%）之间临床上相关的瓣膜反流发生率无显著差异（P=0.16）。平均 MVTa 分别为 1.27+/-0.17 和 1.24+/-0.21 cm²（P=0.54）。瓣膜反流和 MVTa 均与卡麦角林的累积剂量无关。7 例患者的肺功能明显下降需要进一步影像学检查。1 例患者可见可能的早期间质纤维化改变。肺功能损害与卡麦角林的累积剂量无关。
卡麦角林通常用于长期治疗高泌乳素血症或肢端肥大症，似乎不会增加纤维性不良反应的风险。
