title: Effects of combination therapy: somatostatin analogues and dopamine agonists on GH and IGF1 levels in acromegaly.
abstract: OBJECTIVE
  Acromegaly is a complex endocrine disorder caused by excessive secretion of GH, secondary to a GH secreting pituitary adenoma or a mixed pituitary adenoma secreting GH and PRL.
  
  
  METHODS
  The aim of this study was to evaluate the effects of combination therapy: dopamine agonist and somatostatin analogue on GH and IGF1 levels in a group of 30 patients with acromegaly. Cabergoline in a dose of 2 mg/week and 4 mg/week respectively was associated with Sandostatin LAR in a dose of 20 mg/month and 30 mg/months respectively. Eight patients were treated with Lanreotide 30 mg/week and Cabergoline 2 mg/week and 3 patients were treated with Bromocriptine 10 mg/day and Sandostatin LAR 30 mg/month.
  
  
  RESULTS
  Combination therapy: Cabergoline and Sandostatin achieved normal levels of IGF1 in 32% of the patients, better results being obtained after 12 months of treatment in the group treated with 4 mg Cabergoline/week. In 37% of cases the levels of IGF1 decreased by 50% after 12 months of treatment. In the group treated with Cabergoline and Somatuline a normal level of IGF1 was achieved in 25% of patients after 12 months of treatment. The outcome for the group treated with Sandostatin and Bromocriptine was similar to that obtained under Cabergoline 2 mg/week. There was no significant correlation between the level of GH and the type or dose of dopamine agonist used.
  
  
  CONCLUSIONS
  In conclusion, combination therapy consisting of dopamine agonist and somatostatin analogue achieves a significant reduction of IGF1 levels in patients with mixed adenomas secreting GH and PRL. A decrease in IGF1 levels is directly correlated with the dose of Cabergoline used.
authors.affiliation: Department of Endocrinology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Ana
authors.initials: A
authors.lastname: Valea
authors.affiliation: Department of Endocrinology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Cristina
authors.initials: C
authors.lastname: Ghervan
authors.affiliation: Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Mara
authors.initials: M
authors.lastname: Carsote
authors.affiliation: Department of Endocrinology, Cluj-Napoca Clinical County Hospital, Romania.
authors.forename: Andra
authors.initials: A
authors.lastname: Morar
authors.affiliation: Department of Endocrinology, Cluj-Napoca Clinical County Hospital, Romania.
authors.forename: Iulia
authors.initials: I
authors.lastname: Iacob
authors.affiliation: Department of Endocrinology, Cluj-Napoca Clinical County Hospital, Romania.
authors.forename: Florica
authors.initials: F
authors.lastname: Tomesc
authors.affiliation: Department of Radiotherapy, Prof. Dr. Ion Chiricuta Oncology Institute Cluj-Napoca, Romania.
authors.forename: Dan Dumitru
authors.initials: DD
authors.lastname: Pop
authors.affiliation: Department of Endocrinology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania ; Department of Endocrinology, Cluj-Napoca Clinical County Hospital, Romania.
authors.forename: Carmen
authors.initials: C
authors.lastname: Georgescu
keywords: acromegaly; cabergoline; insulin-like growth factor 1; prolactine