title: Treatment with long acting repeatable bromocriptine (Parlodel-LAR*) in patients with macroprolactinomas: long-term study in 29 patients.
abstract: The aim of the study was to evaluate the short term and long-term effects of long acting repeatable bromocriptine (= Parlodel-LAR*) in patients with macroprolactinomas. Twenty-nine patients (15 men and 14 women) aged 42 +/- 2.7 (M +/- SEM) years were injected with Parlodel-LAR* every 4 weeks during 3.3 +/- 0.3 years. The starting dose was 50 mg/injection, then it was increased to 100 mg in 11 patients and 150 mg in 9 patients. PRL levels decreased in all but one patient 4 weeks after the first injection (270 +/- 59 vs 934 +/- 210 ng/ml, p < 0.001), then became less than 20 ng/ml in 20/29 (69%) patients and finally became undetectable or low in 13/29 (45%) patients. Visual field defects were present in 12/29 patients before treatment. In 11/12 patients, treatment with Parlodel-LAR* resulted in an improvement and complete correction of visual field defects was observed in 8/12 patients. Adenoma size (2.5 +/- 0.2 cm before treatment) was reduced by at least 20% in 24/29 (83%) patients. Disappearance of adenoma was observed on CT scan in 8/29 (28%) patients after 28.7 +/- 5.3 months of treatment. Minor side effects occurred in 20 patients after the first injection then disappeared in 18 patients within the following 6 months of treatment. One patient had rhinorrhea after 3 months of treatment. Treatment with Parlodel-LAR* results in beneficial short-term effects (with rapid correction of recent onset visual field defects) and long-term effects (which can include complete disappearance of adenoma on CT scan evaluation) in patients with macroprolactinomas.
authors.affiliation: Department of Endocrinology, CHU Purpan, Toulouse, France.
authors.forename: S I
authors.initials: SI
authors.lastname: Jamrozik
authors.forename: A P
authors.initials: AP
authors.lastname: Bennet
authors.forename: A
authors.initials: A
authors.lastname: James-Deidier
authors.forename: F
authors.initials: F
authors.lastname: Tremollieres
authors.forename: F
authors.initials: F
authors.lastname: Saint-Martin
authors.forename: S
authors.initials: S
authors.lastname: Dumoulin
authors.forename: M
authors.initials: M
authors.lastname: Valat-Coustols
authors.forename: I
authors.initials: I
authors.lastname: de Glisezinski
authors.forename: M
authors.initials: M
authors.lastname: Tremoulet
authors.forename: C
authors.initials: C
authors.lastname: Manelfe
authors.forename: J P
authors.initials: JP
authors.lastname: Louvet
mesh_terms: D000328:Adult; D001971:Bromocriptine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006727:Hormone Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011388:Prolactin / Q000097:blood* / Q000378:metabolism; D015175:Prolactinoma / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014794:Visual Fields / Q000187:drug effects / Q000502:physiology*
chemical_list: D006727:Hormone Antagonists; D001971:Bromocriptine; D011388:Prolactin