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Long-term IGF-1 monitoring in prolactinoma patients treated with cabergoline might not be indicated

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Abstract

Purpose

Cabergoline (CAB) therapy for prolactinomas has been associated with serum IGF-1 levels modifications, with recent reports indicating a paradoxical increase of IGF-1 levels during ongoing therapy. As a result, IGF-1 measurement has been proposed not only at diagnosis of a prolactinoma, but also during follow-up. In this follow-up study on prolactinoma patients with chronic CAB therapy, we investigated whether there are long-term changes in IGF-1 levels that necessitate continuous monitoring.

Methods

We reviewed our institutional database on prolactinoma patients with long-term CAB therapy, in whom IGF-1 levels were measured at baseline, at 3-months follow-up and in the long term.

Results

Chronic CAB therapy was noted in 20 patients (13 men, 7 women). Median (±SD) age was 43.5 ± 12.6 years. 17 (85%) patients presented with a macroprolactinoma. Median CAB treatment time was 75 ± 43 months (range 24–187). Median IGF-1 levels increased at last follow-up, though not significantly; from 122 ± 37 ng/ml (IQR 104–160 ng/ml) to 133 ± 54 (IQR 121–162 ng/ml), p = 0.10. Thereby, 18 (90%) patients showed normal serum IGF-1 levels adjusted for age, one (5%) patient above (1.05 × ULN) and 1 (5%) patient below the normal range (0.34 × ULN). No patient was or became symptomatic of acromegaly.

Conclusion

Our long-term results indicate that chronic treatment with CAB in prolactinoma patients does not significantly modify serum IGF-1 levels. Bearing in mind the sample size of this study, continuing IGF-1 monitoring is not indicated in prolactinoma patients with long-term CAB therapy.

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Authors and Affiliations

  1. Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster Inselspital, Bern University Hospital, Bern, Switzerland

    Lukas Andereggen

  2. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Lukas Andereggen

  3. Department of Gynecology and Obstetrics, Kantonsspital Lucerne, Lucerne, Switzerland

    Janine Frey

  4. Department of Endocrinology, Diabetology and Metabolism, University Hospital of Basel, Basel, Switzerland

    Emanuel Christ

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Correspondence to Lukas Andereggen.

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The Human Research Ethics Committee of Bern (Kantonale Ethikkommision KEK Bern, Bern, Switzerland) approved the project (KEK n° 10-10-2006 and 8-11-2006). The study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Andereggen, L., Frey, J. & Christ, E. Long-term IGF-1 monitoring in prolactinoma patients treated with cabergoline might not be indicated. Endocrine 72, 216–222 (2021). https://doi.org/10.1007/s12020-020-02557-1

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