Neuroendocrinology Research Center /Endocrinology Division, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Neuroendocrinology Division, Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
Clin Endocrinol (Oxf). 2018 Jun;88(6):889-895. doi: 10.1111/cen.13595. Epub 2018 Apr 6.
Few studies evaluated the use of cabergoline (CAB) for acromegaly treatment in monotherapy or in combination with first-generation somatostatin receptor ligands (SRLs).
To evaluate the efficacy, predictors of response and safety of CAB treatment in acromegaly both in monotherapy and in combination with SRLs.
We retrospectively collected demographic, biochemical, tumour and treatment data. Short-term disease control was defined as random GH level < 1.0 μg/L and normal age-matched IGF-I level after 3-6 months of treatment with the higher dose used. Long-term disease control was defined as maintenance of normal GH and IGF-I levels at the last visit (at least 9 months of treatment).
Eighty-two patients were studied. The median total time of treatment in monotherapy or in combination with SRLs was 14 months (3-124) and 34 months (3-88), respectively. Short-term disease control was observed in 6 (21%) patients in the monotherapy group and in 20 (32%) in the combination group. Treatment escape was observed in 1 patient after 16 months of CAB monotherapy and in 6 (30%) patients with combination therapy (after a median of 38 months), resulting in long-term disease control of 18% and 23%, respectively. Hyperprolactinemia was a predictor of response to monotherapy and pretreatment GH level to combination treatment.
We presented the results of the largest single-centre study with CAB in monotherapy and in combination with SRL. The efficacy of CAB in acromegaly seems to be lower than that of other drugs, and treatment escape may occur after a long-term follow-up.
很少有研究评估卡麦角林（CAB）在单药治疗或联合第一代生长抑素受体配体（SRL）治疗肢端肥大症的疗效。
评估 CAB 在肢端肥大症单药治疗和联合 SRL 治疗中的疗效、反应预测因素和安全性。
我们回顾性收集了人口统计学、生化、肿瘤和治疗数据。短期疾病控制定义为在使用较高剂量治疗 3-6 个月后，随机 GH 水平<1.0μg/L 和正常年龄匹配的 IGF-I 水平。长期疾病控制定义为在最后一次就诊时（治疗至少 9 个月）维持正常 GH 和 IGF-I 水平。
共纳入 82 例患者。单药或联合 SRL 治疗的中位总时间分别为 14 个月（3-124）和 34 个月（3-88）。单药治疗组有 6 例（21%）患者和联合治疗组有 20 例（32%）患者达到短期疾病控制。1 例患者在接受 CAB 单药治疗 16 个月后出现治疗逃逸，6 例（30%）患者在联合治疗中出现治疗逃逸（中位时间为 38 个月），导致长期疾病控制率分别为 18%和 23%。高催乳素血症是单药治疗反应的预测因素，而治疗前 GH 水平是联合治疗的预测因素。
我们报告了最大的单中心 CAB 单药和联合 SRL 治疗肢端肥大症的研究结果。CAB 在肢端肥大症中的疗效似乎低于其他药物，并且在长期随访后可能会发生治疗逃逸。
