title: Limited value of cabergoline in Cushing's disease: a prospective study of a 6-week treatment in 20 patients.
abstract: OBJECTIVE
  The role of cabergoline in Cushing's disease (CD) remains controversial. The experience is limited to case reports and few open studies that report the effects determined after ≥1 month of treatment. In prolactinomas and dopamine-responsive GH-secreting tumours, effects of cabergoline are seen within days or weeks. Here, we searched for short-term effects of cabergoline in CD.
  
  
  METHODS
  Twenty patients (19 naïve and one recurrent) were included in a prospective study. Cabergoline was administered in increasing doses of 0.5-5 mg/week over 6 weeks.
  
  
  METHODS
  Urinary free cortisol (UFC) 24 h, morning cortisol and ACTH, and salivary cortisol at 0800, 1600 and 2300 h were determined once weekly throughout. Diurnal curves (six samples) of serum cortisol were measured at start and end.
  
  
  RESULTS
  At study end, the median cabergoline dose was 5 mg, range 2.5-5 mg/week. The prolactin levels, markers of compliance, were suppressed in all patients. During the treatment, hypercortisolism varied, gradual and dose-dependent reductions were not seen. Five patients had a >50% decrease of UFC, three had a >50% rise of UFC. Salivary cortisol at 2300 h showed a congruent >50% change with UFC in two of the five cases with decreased UFC, and in one of the three cases with increased UFC. One patient with decreases in both UFC and 2300 h salivary cortisol also had a reduction in diurnal serum cortisol during the course of the study.
  
  
  CONCLUSIONS
  Cabergoline seems to be of little value in the management of CD. Only one patient had a response-like pattern. Given the known variability of disease activity in CD, this might represent a chance finding.
authors.forename: Pia
authors.initials: P
authors.lastname: Burman
authors.affiliation: Department of EndocrinologySkane University Hospital Malmö, University of Lund, 20502 Malmö, SwedenDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Uppsala University, Uppsala, SwedenDepartments of Endocrinology and Medical and Health SciencesLinköping University, Linköping, SwedenDepartment of Internal MedicineFaculty of Medicine and Health, Örebro University, Örebro, Sweden.
authors.forename: Britt
authors.initials: B
authors.lastname: Edén-Engström
authors.affiliation: Department of EndocrinologySkane University Hospital Malmö, University of Lund, 20502 Malmö, SwedenDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Uppsala University, Uppsala, SwedenDepartments of Endocrinology and Medical and Health SciencesLinköping University, Linköping, SwedenDepartment of Internal MedicineFaculty of Medicine and Health, Örebro University, Örebro, Sweden.
authors.forename: Bertil
authors.initials: B
authors.lastname: Ekman
authors.affiliation: Department of EndocrinologySkane University Hospital Malmö, University of Lund, 20502 Malmö, SwedenDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Uppsala University, Uppsala, SwedenDepartments of Endocrinology and Medical and Health SciencesLinköping University, Linköping, SwedenDepartment of Internal MedicineFaculty of Medicine and Health, Örebro University, Örebro, Sweden.
authors.forename: F Anders
authors.initials: FA
authors.lastname: Karlsson
authors.affiliation: Department of EndocrinologySkane University Hospital Malmö, University of Lund, 20502 Malmö, SwedenDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Uppsala University, Uppsala, SwedenDepartments of Endocrinology and Medical and Health SciencesLinköping University, Linköping, SwedenDepartment of Internal MedicineFaculty of Medicine and Health, Örebro University, Örebro, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Schwarcz
authors.affiliation: Department of EndocrinologySkane University Hospital Malmö, University of Lund, 20502 Malmö, SwedenDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Uppsala University, Uppsala, SwedenDepartments of Endocrinology and Medical and Health SciencesLinköping University, Linköping, SwedenDepartment of Internal MedicineFaculty of Medicine and Health, Örebro University, Örebro, Sweden.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Wahlberg
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000368:Aged; D000077465:Cabergoline; D002940:Circadian Rhythm; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004873:Ergolines / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis / Q000097:blood / Q000652:urine; D008297:Male; D008875:Middle Aged; D047748:Pituitary ACTH Hypersecretion / Q000188:drug therapy*; D011446:Prospective Studies; D012463:Saliva / Q000737:chemistry
chemical_list: D018491:Dopamine Agonists; D004873:Ergolines; D000324:Adrenocorticotropic Hormone; D000077465:Cabergoline; D006854:Hydrocortisone