Limited value of cabergoline in Cushing's disease: a prospective study of a 6-week treatment in 20 patients

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Burman, PiaLund University,Lunds universitet,Genomik, diabetes och endokrinologi,Forskargrupper vid Lunds universitet,Genomics, Diabetes and Endocrinology,Lund University Research Groups,Lund Univ, Skane Univ Hosp Malmo, Dept Endocrinol, S-20502 Malmo, Sweden.,Department of Endocrinology, Skane University Hospital Malmö, University of Lund, Malmö, Sweden (author)

Limited value of cabergoline in Cushing's disease : a prospective study of a 6-week treatment in 20 patients

Article/chapterEnglish2016

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Bioscientifica,2016
printrdacarrier

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LIBRIS-ID:oai:DiVA.org:oru-110281
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-110281URI
https://doi.org/10.1530/EJE-15-0807DOI
https://lup.lub.lu.se/record/8235179URI
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-272040URI
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-124115URI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Funding Agencies:Swedish Association of Local Authorities and RegionsLocal grants from University of Lund, Linköping and Uppsala
Funding Agencies|Swedish Association of Local Authorities and Regions to the Swedish Pituitary Study Group; University of Lund; Linkoping; Uppsala
CONTEXT AND OBJECTIVE: The role of cabergoline in Cushing's disease (CD) remains controversial. The experience is limited to case reports and few open studies that report the effects determined after ≥1 month of treatment. In prolactinomas and dopamine-responsive GH-secreting tumours, effects of cabergoline are seen within days or weeks. Here, we searched for short-term effects of cabergoline in CD.DESIGN: Twenty patients (19 naïve and one recurrent) were included in a prospective study. Cabergoline was administered in increasing doses of 0.5-5 mg/week over 6 weeks.METHODS: Urinary free cortisol (UFC) 24 h, morning cortisol and ACTH, and salivary cortisol at 0800, 1600 and 2300 h were determined once weekly throughout. Diurnal curves (six samples) of serum cortisol were measured at start and end.RESULTS: At study end, the median cabergoline dose was 5 mg, range 2.5-5 mg/week. The prolactin levels, markers of compliance, were suppressed in all patients. During the treatment, hypercortisolism varied, gradual and dose-dependent reductions were not seen. Five patients had a >50% decrease of UFC, three had a >50% rise of UFC. Salivary cortisol at 2300 h showed a congruent >50% change with UFC in two of the five cases with decreased UFC, and in one of the three cases with increased UFC. One patient with decreases in both UFC and 2300 h salivary cortisol also had a reduction in diurnal serum cortisol during the course of the study.CONCLUSIONS: Cabergoline seems to be of little value in the management of CD. Only one patient had a response-like pattern. Given the known variability of disease activity in CD, this might represent a chance finding.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Endokrinologi och diabetes hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Endocrinology and Diabetes hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine hsv//eng

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Edén-Engström, BrittUppsala universitet,Endokrinologi och mineralmetabolism,Department of Diabetes, Endocrinology and Metabolism, University Hospital, Uppsala University, Uppsala, Sweden(Swepub:uu)brittee (author)
Ekman, BertilLinköpings universitet,Medicinska fakulteten,Avdelningen för kardiovaskulär medicin,Region Östergötland, Endokrinmedicinska kliniken(Swepub:liu)berek83 (author)
Karlsson, Anders F.Uppsala universitet,Klinisk diabetologi och metabolism,Department of Diabetes, Endocrinology and Metabolism, University Hospital, Uppsala University, Uppsala, Sweden(Swepub:uu)anderska (author)
Schwarcz, ErikDepartment of Internal Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden,Univ Orebro, Fac Med & Hlth, Dept Internal Med, SE-70182 Orebro, Sweden. (author)
Wahlberg, Jeanette,1969-Linköpings universitet,Medicinska fakulteten,Avdelningen för kardiovaskulär medicin,Region Östergötland, Endokrinmedicinska kliniken(Swepub:liu)jeawa98 (author)
Genomik, diabetes och endokrinologiForskargrupper vid Lunds universitet (creator_code:org_t)

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In:European Journal of Endocrinology: Bioscientifica174:1, s. 17-240804-46431479-683X

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