Treatment of macroprolactinoma with the new potent non-ergot D2-dopamine agonist quinagolide and effects on prolactin levels, pituitary function, an the renin-aldosterone system. Results of a clinical long-term study.
The oral non-ergot D2-dopamine agonist quinagolide (CV 205-502, CAS 87056-78-8) has proven to be highly effective in suppressing elevated prolactin (PRL) levels. It was the aim of this study to search for possible interference of the drug with other endocrine systems which are partly under dopaminergic control, and to compare such effects to those of previously investigated prolactin inhibitors. Twelve patients suffering from macroprolactinoma were treated for at least 6 months with daily doses ranging from 50 up to 300 micrograms. During the first two months, individual doses were gradually increased either until serum PRL levels reached the normal range (n = 7) or until side effects made a further dose increase intolerable (n = 5). Mean basal PRL level fell from 255 +/- 65 (SEM) ng/ml before treatment to 19 +/- 8 ng/ml, after the definite dose was reached (p < 0.01). Luteinizing hormone (LH) rose from 0.6 +/- 0.8 (SD) to 1.7 +/- 1.6 mU/ml (p < 0.05). While basal levels of aldosterone, renin, follicle-stimulating hormone (FSH), triiodothyronine (T3), testosterone, and estradiol in females were not affected by the treatment, we found a significant rise in thyroxine (T4) and a decrease of estradiol in males. Blood pressure and renal clearances of creatinine, sodium, potassium, and chloride failed to show any significant change. Following stimulation with metoclopramide, aldosterone and renin rose sharply before treatment was initiated. When the test was repeated during treatment, the increase of plasma renin was slightly dampened, whereas the rise of aldosterone remained unaffected.(ABSTRACT TRUNCATED AT 250 WORDS)
Nickelsen
T
T
Abteilung für Endokrinology, Johann Wolfgang Goethe-Universität, Frankfurt/Main Fed. Rep. of Germany.
Jungmann
E
E
Althoff
P
P
Schumm-Draeger
P M
PM
Usadel
K H
KH
D000328:Adult; D000368:Aged; D000634:Aminoquinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D015259:Dopamine Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006062:Gonadotropins / Q000097:blood; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008787:Metoclopramide / Q000494:pharmacology; D008875:Middle Aged; D010902:Pituitary Gland / Q000503:physiopathology*; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D011388:Prolactin / Q000097:blood*; D015175:Prolactinoma / Q000188:drug therapy* / Q000503:physiopathology; D017448:Receptors, Dopamine D2 / Q000187:drug effects*; D012084:Renin-Angiotensin System / Q000187:drug effects*; D013973:Thyrotropin-Releasing Hormone / Q000494:pharmacology
D000634:Aminoquinolines; D015259:Dopamine Agents; D012739:Gonadal Steroid Hormones; D006062:Gonadotropins; D017448:Receptors, Dopamine D2; D013973:Thyrotropin-Releasing Hormone; C046650:quinagolide; D011388:Prolactin; D008787:Metoclopramide