Botelho Mayra Souza, Franzini Ítalo Antunes, Nunes-Nogueira Vania Dos Santos, Boguszewski Cesar Luiz
Department of Internal Medicine, Medical School, São Paulo State University, UNESP, Avenida Professor Mário Rubens Guimarães Montenegro s/n, Bairro UNESP, Campus Botucatu, Botucatu, SP, 18618-687, Brazil.
Department of Internal Medicine, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), University of São Paulo, São Paulo, Brazil.
Pituitary. 2022 Dec;25(6):810-818. doi: 10.1007/s11102-022-01257-5. Epub 2022 Jul 28.
To make a systematic review and meta-analysis of studies evaluating the effect of cabergoline (CBG) in the treatment of non-functioning pituitary adenomas (NFPAs).
The primary outcome was tumor shrinkage, using as cut-off a reduction of at least 20% of the NFPA size from baseline. The secondary outcomes were prevention of tumor progression, clinically required additional interventions and adverse events (AE). Search strategies were applied to MEDLINE, EMBASE, LILACS and CENTRAL. Independent reviewers assessed the study eligibility, extracted data, and evaluated risk of bias. Random meta-analysis for the proportion of tumor shrinkage, prevention of tumor progression, clinically required additional interventions and frequency of AE were conducted.
Five studies were included. The meta-analysis of proportion was 19% for tumor shrinkage (95% CI 8-38%, 4 studies, 108 participants), 50% for prevention of tumor progression (95% CI 35-64%, 5 studies, 187 participants), 14% for clinically required additional interventions (95% CI 6-30%, 4 studies, 128 participants) and 2% for adverse events (95% CI 1-6%, 3 studies, 157 participants).
Effect of CBG to promote tumor shrinkage in NFPAs was low, while prevention of tumor progression after surgery was seen in half of the cases, with a low frequency of adverse events.
PROSPERO CRD42020206778.
对评估卡麦角林（CBG）治疗无功能垂体腺瘤（NFPA）效果的研究进行系统评价和荟萃分析。
主要结局为肿瘤缩小，以NFPA大小较基线至少减少20%作为截断值。次要结局为预防肿瘤进展、临床所需的额外干预措施和不良事件（AE）。检索策略应用于MEDLINE、EMBASE、LILACS和CENTRAL。独立 reviewers 评估研究的纳入资格、提取数据并评估偏倚风险。对肿瘤缩小比例、预防肿瘤进展、临床所需的额外干预措施和AE发生频率进行随机荟萃分析。
纳入5项研究。肿瘤缩小比例的荟萃分析结果为19%（95%CI 8 - 38%，4项研究，108名参与者），预防肿瘤进展为50%（95%CI 35 - 64%，5项研究，187名参与者），临床所需额外干预措施为14%（95%CI 6 - 30%，4项研究，128名参与者），不良事件为2%（95%CI 1 - 6%，3项研究，157名参与者）。
CBG促进NFPA肿瘤缩小的效果较低，而手术后半数病例可见预防肿瘤进展，不良事件发生频率较低。
PROSPERO CRD42020206778 。
