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Cabergoline therapy cessation leads to short-term remission for macroprolactinomas
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Nearly 75% of adults with macroprolactinomas who discontinued cabergoline therapy after 5 years experienced disease remission for at least 12 months, study data show.
Hiroyoshi Akutsu, MD, PhD, of the department of neurosurgery, faculty of medicine at the University of Tsukuba in Japan, and colleagues analyzed data from 46 adults with macroprolactinomas treated with cabergoline from 2003 to 2013 to determine long-term results of cabergoline therapy and remission after withdrawal. Participants were treated with cabergoline for 5 years before withdrawal.
After initiation of cabergoline therapy, the median follow-up period was 54.3 months. Prolactin normalization occurred in 89% of participants, with a median time to normalization of 2.8 months. Information on pretreatment MRI was available for 45 participants; the tumor disappeared in 38%, shrank in 47% and did not change in 16%.
Cabergoline therapy for 5 years was completed by 21 participants, and 11 underwent cabergoline withdrawal. Recurrences developed in 27% after withdrawal. However, true disease recurrence manifesting as exacerbation of clinical symptoms or tumor enlargement was not experienced by any of the 11 participants who achieved withdrawal. Remission was reached by 73% for at least 12 months after discontinuing cabergoline therapy.
Remission was significantly related to absence of at least three-quarters encasement of the intracavernous internal carotid artery (P = .006), prolactin of 132.7 ng/mL or lower before starting therapy (P = .03), and prolactin 1.9 ng/mL or lower during cabergoline therapy (P = .04), according to the researchers. – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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