[en] Twenty-nine patients with macroprolactinomas were treated by monthly intramuscular injections of the long-acting and repeatable form of bromocriptine (Parlodel-LAR) in doses ranging from 50-150 mg. They were divided into two groups: group I consisted of 22 patients who received Parlodel LAR before transsphenoidal adenomectomy; group II was composed of 7 patients with earlier neurosurgery and of 2 patients from group I not cured by transsphenoidal adenomectomy. Duration of therapy varied from 1-12 months, and a total of 104 injections was given. At nadir day, serum PRL levels were situated between less than 1% and 43% of pretreatment values. At day 28 after the first injection, serum PRL levels varied between less than 1% to 139% of initial values. No difference could be detected between the two groups regarding the percent of PRL inhibition. Long-term treatment with Parlodel-LAR resulted in a sustained inhibition of PRL secretion, except for 1 case. Resumption of menstrual cycles occurred in 4 out of 15 women and correction of hypogonadism in 4 out of 14 men. Amelioration of disturbed visual fields was recorded in 3 out of 8 patients. Diminution of the adenoma volume was radiologically documented in 14 out of 22 cases. Only few and mild side effects were recorded. One patient with partial adrenal deficiency suffered from a syncope, but this was prevented by hydrocortisone supplementation during the subsequent Parlodel-LAR administration. In conclusion, Parlodel-LAR proved effective in the treatment of macroprolactinomas, achieving rapid inhibition of PRL secretion, and in some patients amelioration of hypopituitarism, reduction in tumor size, and improvement in visual fields, and caused no serious side effects. It is a valuable preparation to surgery and can also be used in long-term medical therapy.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Beckers, Albert ; Université de Liège - ULiège > Département des sciences cliniques > Endocrinologie
Petrossians, Patrick ; Centre Hospitalier Universitaire de Liège - CHU > Endocrinologie clinique
Abs, R.
Flandroy, P.
Stadnik, T.
De Longueville, M.
Lancranjan, I.
Stevenaert, Achille ; Centre Hospitalier Universitaire de Liège - CHU > Neurochirurgie
Language :
English
Title :
Treatment of macroprolactinomas with the long-acting and repeatable form of bromocriptine: a report on 29 cases.
Publication date :
1992
Journal title :
Journal of Clinical Endocrinology and Metabolism
ISSN :
0021-972X
eISSN :
1945-7197
Publisher :
Endocrine Society, Chevy Chase, United States - Maryland
Dalkin AC, Marshall JC. 1989 Medical therapy of hyperprolactinemia. Endocrinol Metab Clin North Am. 18:259-76.
Spark RF, Baker R, Bienfang DC, Bergland R. 1982 Bromocriptine reduces pituitary tumor size and hypersecretion. JAMA. 247:311-6.
Thorner MO, Martin WH, Rogol AD, et al. 1980 Rapid regression of pituitary prolactinomas during bromocriptine treatment. J Clin Endocrinol Metab. 51:438-45.
Warfield A, Finkel DM, Schatz NJ, et al. 1984 Bromocriptine treatment of prolactin-secreting adenomas may restore pituitary function. Ann Intern Med. 101:783-5.
Beckers A, Stevenaert A, Pirens G, Flandroy P, Sulon J, Hennen G. 1990 Cyclical Cushing's disease and it's successful control under sodium valproate. J Endocrinol Invest. 13:923-9.
Beckers A, Abs R, Mahler Ch, et al. 1991 Thyrotropin-secreting pituitary adenomas: report of seven cases. J Clin Endocrinol Metab. 72:477-83.
Molitch ME, Elton RL, Blackwell RE, et al. 1985 Bromocriptine as primary therapy for prolactin-secreting macroadenomas: result of a prospective multicenter study. J Clin Endocrinol Metab. 60:698-705.
Serri O, Beauregard H, Lesage J, et al. 1990 Long term treatment with CV 205-502 in patients with prolactin-secreting pituitary macroadenomas. J Clin Endocrinol Metab. 71:683-7.
van der Lely AJ, Brownell J, Lamberts SWJ. 1991 The efficacy and tolerability of CV 205-502 (a nonergot dopaminergic drug) in macroprolactinoma patients and in prolactinoma patients intolerant to bromocriptine. J Clin Endocrinol Metab. 72:1136-41.
van 't Verlaat JW, Lancranjan I, Hendriks MJ, Croughs RJM. 1988 Primary treatment of macroprolactinomas with Parlodel LAR. Acta Endocrinol (Copenh). 119:51-5.
Ciccarelli E, Miola C, Avataneo T, Camanni F, Besser MG, Grossman A. 1989 Long-term treatment with a new repeatable injectable form of bromocriptine, Parlodel LAR,® in patients with tumorous hyperprolactinemia. Fertil Steril. 52:930-5.
Kocijancic A, Prezelj J, Vrhovec I, Lancranjan I. 1990 Parlodel LAR® in the treatment of macroprolactinomas. Acta Endocrinol (Copenh). 122:272-6.