Abstract
Acromegaly, a rare disease due to growth hormone (GH) hypersecretion by a pituitary adenoma, is associated with severe comorbidity and premature death if not adequately treated. The usual first-line treatment is surgery. Various drugs, including somatostatin receptor ligands, dopamine agonists and GH receptor antagonists, are now available for use if surgery fails to suppress GH/IGF-I hypersecretion. Cabergoline, now the preferred dopamine agonist for treating hyperprolactinemia, is also used off-label for treating acromegaly. Cabergoline monotherapy is reported to normalize IGF-I levels in more than one-third of patients with acromegaly. When a somatostatin receptor ligand proves ineffective, cabergoline add-on therapy normalizes the IGF-I level in 40–50% of patients. Finally, when combined with the GH receptor antagonist pegvisomant in patients with mild uncontrolled disease, cabergoline helps to achieve normal IGF-I levels while avoiding the need for high-dose pegvisomant. Cabergoline is also inexpensive and well tolerated; in particular, it does not appear to promote heart valve disease.
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EK declares that she has no conflict of interest. PC. has received unrestricted research and educational grants from Ipsen, Novartis and Pfizer as Head of the Department of Endocrinology and Reproductive Diseases, Hôpitaux Universitaires Paris-Sud. PC has served as investigator (principal or coordinator) for clinical trials funded by Novartis, Pfizer, Ipsen, Italpharmaco, Antisense. PC is member of Advisory Boards from Ipsen, Novartis. PC gave lectures for Ipsen, Novartis, and Pfizer. All the fees and honoraria are paid to his Institution.
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Kuhn, E., Chanson, P. Cabergoline in acromegaly. Pituitary 20, 121–128 (2017). https://doi.org/10.1007/s11102-016-0782-6
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DOI: https://doi.org/10.1007/s11102-016-0782-6