Navegando por Palavras-chave "Prolactinoma"

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    Resposta da prolactina à metformina em prolactinomas resistentes à cabergolina: um estudo piloto
    (Universidade Federal de São Paulo (UNIFESP), 2020-12-18) Portari, Luiz Henrique Correa [UNIFESP]; Abucham Filho, Julio Zaki [UNIFESP]; Universidade Federal de São Paulo
    Context: Cabergoline is the treatment of choice for prolactinomas. However, 10-20% of prolactinomas are resistant to cabergoline. Metformin, a biguanide widely used in the treatment of diabetes mellitus, has been shown to reduce prolactin secretion in various pituitary tumor cell lineages both in vitro and in vivo and in human pituitary adenomas in vitro. Objective: To test the effects of metformin addition to cabergoline treatment on prolactin levels in patients with resistant prolactinomas. Design: Prospective. Setting: Outpatient clinic in a reference center. Patients: Ten adult patients (26-61 y) with prolactinomas (7M), persistent hyperprolactinemia (38-386 ng/ mL) under cabergoline treatment (2-7 mg/week), at least six months of treatment (6- 108 mo), and features of metabolic syndrome were included. Intervention: Metformin (1.0-2.5 g v.o./d) was given according to patients´ tolerance. Cabergoline doses were kept unchanged. Main Outcome Measure: Serum prolactin levels were measured before and after short- (30-60 d) and long- term (120-180 d) metformin treatment. Results: Mean prolactin levels did not show any significant changes (148 ± 39 ng/ml vs 138 ± 42 ng/ml vs 133 ± 39 ng/ml, before, at 30-60 days, and at 120- 180 days, respectively, P=0.196) after metformin (mean dose: 1.25 g/day; range: 1.0- 2.0 g/day). No patient reached a normal prolactin level during metformin treatment. Two patients were considered partial responders for exhibiting prolactin decreases ≥50% at a single time point during metformin. Conclusions: Metformin addition to ongoing high dose cabergoline treatment in patients with cabergoline-resistant prolactinomas failed to show a consistent inhibitory effect in serum prolactin levels.