Short- and Long-Term Efficacy of Combined Cabergoline and Octreotide Treatment in Controlling IGF-I Levels in Acromegaly

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dc.contributor.authorMattar, Priscilla
dc.contributor.authorAlves Martins, Manoel Ricardo
dc.contributor.authorAbucham, Julio [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T13:59:09Z
dc.date.available2016-01-24T13:59:09Z
dc.date.issued2010-01-01
dc.description.abstractObjective: Nearly 40% of acromegalic patients fail to control GH/IGF-I levels with somatostatin analogues (SA). Dopaminergic agonists (DA) are even less effective, but combination therapy with SA and DA normalizes IGF-I levels in 33-56% of patients not controlled by octreotide alone in short-term studies. This study was designed to evaluate short-and long-term efficacy of cabergoline in controlling IGF-I levels in acromegalic patients receiving octreotide. Design: Open-label, single arm, prospective trial. Nineteen patients (14 females, 29-78 years of age) with high IGF-I on octreotide-LAR (30 mg/month IM) for >= 6 months were enrolled. Study I: Cabergoline (PO) was started at 1.0, increased to 2.0 and 3.5 mg/week, and withdrawn at 6-week intervals. IGF-I, GH, and PRL were measured at baseline and at 6-week intervals. Study II: Responder patients (IGF-I <= 1 ULN) resumed cabergoline at individual lowest effective doses and were evaluated at 6-month intervals for >= 12 months. Study III: Responders were withdrawn from octreotide and hormonally evaluated at 3-month intervals. Methods: Serum IGF-I (IRMA), GH (ICMA) and PRL (ICMA) levels were determined by commercially available kits. Results: Addition of cabergoline to octreotide-LAR normalized IGF-I levels in 7 of 19 patients (37%) during both short-and long-term follow-up (12-27 months, mean: 18 months). Octreotide withdrawal increased IGF-I levels in only 2 of 6 responder patients. Normalization of IGF-I levels by cabergoline was strongly associated with IGF-I <= 2.2 ULNR and/or GH <= 4.0 ng/ml under octreotide treatment. Conclusion: Addition of cabergoline to octreotide was effective in both short-and long-term control of IGF-I in acromegaly, especially in patients with mild/moderately elevated GH/IGF-I levels during octreotide. Copyright (C) 2010 S. Karger AG, Baselen
dc.description.affiliationUniversidade Federal de São Paulo, Escola Paulista Med, Disciplina Endocrinol, Neuroendocrine Unit,Div Endocrinol,Dept Med, BR-04039002 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Escola Paulista Med, Disciplina Endocrinol, Neuroendocrine Unit,Div Endocrinol,Dept Med, BR-04039002 São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent120-127
dc.identifierhttp://dx.doi.org/10.1159/000317314
dc.identifier.citationNeuroendocrinology. Basel: Karger, v. 92, n. 2, p. 120-127, 2010.
dc.identifier.doi10.1159/000317314
dc.identifier.issn0028-3835
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/32155
dc.identifier.wosWOS:000281230300004
dc.language.isoeng
dc.publisherKarger
dc.relation.ispartofNeuroendocrinology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.karger.com/Services/RightsPermissions
dc.subjectAcromegalyen
dc.subjectCabergolineen
dc.subjectProlactinen
dc.titleShort- and Long-Term Efficacy of Combined Cabergoline and Octreotide Treatment in Controlling IGF-I Levels in Acromegalyen
dc.typeinfo:eu-repo/semantics/article
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