Department of Medicine: Endocrinology and Metabolism, Emory University, Atlanta, GA 30322, USA.
Department of Medicine: Endocrinology and Metabolism, Emory University, Atlanta, GA 30322, USA; Department of Neurosurgery, Emory University, Atlanta, GA, USA.
Endocrinol Metab Clin North Am. 2020 Sep;49(3):453-474. doi: 10.1016/j.ecl.2020.05.006. Epub 2020 Jul 15.
Dopamine agonist therapy is the primary therapy for prolactin-secreting adenomas and usually results in normoprolactinemia, eugonadism, and tumor reduction. Cabergoline is superior to bromocriptine with regard to efficacy and tolerance. Withdrawal of cabergoline can be attempted in patients with normal prolactin levels on low doses of medication and evidence of radiographic tumor involution. Dopamine agonists have been used off label in patients with acromegaly, Cushing disease, and nonfunctioning adenomas. A trial of cabergoline monotherapy can be effective in patients with biochemically mild acromegaly. Cabergoline combination with somatostatin receptor ligands or pegvisomant improves insulin-like growth factor level 1 in majority of patients.
多巴胺激动剂治疗是催乳素分泌腺瘤的主要治疗方法，通常可导致正常催乳素血症、正常性腺功能和肿瘤缩小。卡麦角林在疗效和耐受性方面优于溴隐亭。对于低剂量药物且影像学显示肿瘤退缩的患者，可以尝试停用卡麦角林。多巴胺激动剂已在肢端肥大症、库欣病和无功能腺瘤患者中被超适应证使用。卡麦角林单药治疗可有效治疗生化轻度肢端肥大症患者。卡麦角林联合生长抑素受体配体或培维索孟可改善大多数患者的胰岛素样生长因子 1 水平。
