title: Cabergoline for Cushing's disease: a large retrospective multicenter study.
abstract: OBJECTIVE
  The efficacy of cabergoline in Cushing's disease (CD) is controversial. The aim of this study was to assess the efficacy and tolerability of cabergoline in a large contemporary cohort of patients with CD.
  
  
  METHODS
  We conducted a retrospective multicenter study from thirteen French and Belgian university hospitals.
  
  
  METHODS
  Sixty-two patients with CD received cabergoline monotherapy or add-on therapy. Symptom score, biological markers of hypercortisolism and adverse effects were recorded.
  
  
  RESULTS
  Twenty-one (40%) of 53 patients who received cabergoline monotherapy had normal urinary free cortisol (UFC) values within 12 months (complete responders), and five of these patients developed corticotropic insufficiency. The fall in UFC was associated with significant reductions in midnight cortisol and plasma ACTH, and with clinical improvement. Compared to other patients, complete responders had similar median baseline UFC (2.0 vs 2.5xULN) and plasma prolactin concentrations but received lower doses of cabergoline (1.5 vs 3.5 mg/week, P < 0.05). During long-term treatment (>12 months), cabergoline was withdrawn in 28% of complete responders because of treatment escape or intolerance. Overall, sustained control of hypercortisolism was obtained in 23% of patients for 32.5 months (19-105). Nine patients on steroidogenesis inhibitors received cabergoline add-on therapy for 19 months (1-240). Hypercortisolism was controlled in 56% of these patients during the first year of treatment with cabergoline at 1.0 mg/week (0.5-3.5).
  
  
  CONCLUSIONS
  About 20-25% of CD patients are good responders to cabergoline therapy allowing long-term control of hypercortisolism at relatively low dosages and with acceptable tolerability. No single parameter, including the baseline UFC and prolactin levels, predicted the response to cabergoline.
authors.affiliation: CHU BordeauxHôpital Haut-Lévêque, Service d'Endocrinologie, Diabétologie et Nutrition, Pessac, France or INSERM U862, Neurocentre Magendie, Université Bordeaux, Bordeaux Cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Ferriere
authors.affiliation: CHRU LilleService d'Endocrinologie, Diabétologie et Métabolisme, Lille Cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Cortet
authors.affiliation: Assistance Publique-Hôpitaux de ParisHôpitaux universitaires Paris-Sud, Hôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Le Kremlin Bicêtre, France.
authors.forename: P
authors.initials: P
authors.lastname: Chanson
authors.affiliation: CHU ReimsHôpital Robert Debré, Service d'Endocrinologie, Diabétologie et Nutrition, Reims, France.
authors.forename: B
authors.initials: B
authors.lastname: Delemer
authors.affiliation: CHU ToulouseHôpital Larrey, Service d'Endocrinologie, Maladies Métaboliques et Nutrition, Toulouse cedex 9, France.
authors.forename: P
authors.initials: P
authors.lastname: Caron
authors.affiliation: CHU Grenoble AlpesService d'Endocrinologie-Diabétologie, Boulevard de la Chantourne, La Tronche, France.
authors.forename: O
authors.initials: O
authors.lastname: Chabre
authors.affiliation: CHU CaenService d'Endocrinologie-Diabétologie, CAEN cedex 9, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Reznik
authors.affiliation: Assistance Publique-Hôpitaux de ParisHôpitaux universitaires Paris-Centre, Hôpital Cochin, Service d'Endocrinologie et Maladies Métaboliques, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Bertherat
authors.affiliation: CHU AngersDépartement d'Endocrinologie-Diabétologie-Nutrition, Angers Cedex 9, France.
authors.forename: V
authors.initials: V
authors.lastname: Rohmer
authors.affiliation: CHU AngersDépartement d'Endocrinologie-Diabétologie-Nutrition, Angers Cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Briet
authors.affiliation: CHU MontpellierService d'Endocrinologie, Diabète, Maladies métaboliques, Montpellier, France.
authors.forename: I
authors.initials: I
authors.lastname: Raingeard
authors.affiliation: Assistance Publique-Hôpitaux de MarseilleHôpital de la Conception, Service d'Endocrinologie, Diabètes et Maladies Métaboliques, Marseille, France.
authors.forename: F
authors.initials: F
authors.lastname: Castinetti
authors.affiliation: CHU LiègeService d'Endocrinologie, Domaine Universitaire du Sart Tilman, Liège, Belgique.
authors.forename: A
authors.initials: A
authors.lastname: Beckers
authors.affiliation: CHU LiègeService d'Endocrinologie, Domaine Universitaire du Sart Tilman, Liège, Belgique.
authors.forename: L
authors.initials: L
authors.lastname: Vroonen
authors.affiliation: Clinique Universitaire Saint LucService d'Endocrinologie et de Nutrition, Bruxelles, Belgique.
authors.forename: D
authors.initials: D
authors.lastname: Maiter
authors.affiliation: CHU Pointe à PitreService d'Endocrinologie, Pointe à Pitre, France.
authors.forename: F L
authors.initials: FL
authors.lastname: Cephise-Velayoudom
authors.affiliation: CHU BordeauxHôpital Haut-Lévêque, Service d'Endocrinologie, Diabétologie et Nutrition, Pessac, France or INSERM U862, Neurocentre Magendie, Université Bordeaux, Bordeaux Cedex, France.
authors.forename: M L
authors.initials: ML
authors.lastname: Nunes
authors.affiliation: CHU BordeauxHôpital Haut-Lévêque, Service d'Endocrinologie, Diabétologie et Nutrition, Pessac, France or INSERM U862, Neurocentre Magendie, Université Bordeaux, Bordeaux Cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Haissaguerre
authors.affiliation: CHU BordeauxHôpital Haut-Lévêque, Service d'Endocrinologie, Diabétologie et Nutrition, Pessac, France or INSERM U862, Neurocentre Magendie, Université Bordeaux, Bordeaux Cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Tabarin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000077465:Cabergoline; D002648:Child; D004873:Ergolines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000652:urine*; D008297:Male; D008875:Middle Aged; D047748:Pituitary ACTH Hypersecretion / Q000188:drug therapy* / Q000652:urine; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004873:Ergolines; D000077465:Cabergoline; D006854:Hydrocortisone