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Treatment of non-functioning pituitary adenoma with cabergoline: a systematic review and meta-analysis

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Abstract

Purpose

To make a systematic review and meta-analysis of studies evaluating the effect of cabergoline (CBG) in the treatment of non-functioning pituitary adenomas (NFPAs).

Methods

The primary outcome was tumor shrinkage, using as cut-off a reduction of at least 20% of the NFPA size from baseline. The secondary outcomes were prevention of tumor progression, clinically required additional interventions and adverse events (AE). Search strategies were applied to MEDLINE, EMBASE, LILACS and CENTRAL. Independent reviewers assessed the study eligibility, extracted data, and evaluated risk of bias. Random meta-analysis for the proportion of tumor shrinkage, prevention of tumor progression, clinically required additional interventions and frequency of AE were conducted.

Results

Five studies were included. The meta-analysis of proportion was 19% for tumor shrinkage (95% CI 8–38%, 4 studies, 108 participants), 50% for prevention of tumor progression (95% CI 35–64%, 5 studies, 187 participants), 14% for clinically required additional interventions (95% CI 6–30%, 4 studies, 128 participants) and 2% for adverse events (95% CI 1–6%, 3 studies, 157 participants).

Conclusions

Effect of CBG to promote tumor shrinkage in NFPAs was low, while prevention of tumor progression after surgery was seen in half of the cases, with a low frequency of adverse events.

Systematic review registration

PROSPERO CRD42020206778.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Internal Medicine, Medical School, São Paulo State University, UNESP, Avenida Professor Mário Rubens Guimarães Montenegro s/n, Bairro UNESP, Campus Botucatu, Botucatu, SP, 18618-687, Brazil

    Mayra Souza Botelho & Vania dos Santos Nunes-Nogueira

  2. Department of Internal Medicine, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), University of São Paulo, São Paulo, Brazil

    Ítalo Antunes Franzini

  3. SEMPR, Endocrine Division, Department of Internal Medicine, Federal University of Parana, Curitiba, Brazil

    Cesar Luiz Boguszewski

Authors
  1. Mayra Souza Botelho
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  2. Ítalo Antunes Franzini
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  3. Vania dos Santos Nunes-Nogueira
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  4. Cesar Luiz Boguszewski
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Contributions

CLB and VSNN conceptualized and designed the study. VSNN and MSB developed the search strategies. MSB and IAF independently screened eligible studies and extracted data from included studies. MSB and IAF assessed in pairs and independently the risk of bias. VSNN and CLB performed the meta-analyses. CLB and VSNN supervised all the phases of this review and refereed any disagreement to avoid errors. All authors contributed to the article and approved the submitted version.

Corresponding author

Correspondence to Vania dos Santos Nunes-Nogueira.

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Botelho, M.S., Franzini, Í.A., Nunes-Nogueira, V. et al. Treatment of non-functioning pituitary adenoma with cabergoline: a systematic review and meta-analysis. Pituitary 25, 810–818 (2022). https://doi.org/10.1007/s11102-022-01257-5

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  • DOI: https://doi.org/10.1007/s11102-022-01257-5

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