title: Cabergoline in acromegaly.
abstract: Acromegaly, a rare disease due to growth hormone (GH) hypersecretion by a pituitary adenoma, is associated with severe comorbidity and premature death if not adequately treated. The usual first-line treatment is surgery. Various drugs, including somatostatin receptor ligands, dopamine agonists and GH receptor antagonists, are now available for use if surgery fails to suppress GH/IGF-I hypersecretion. Cabergoline, now the preferred dopamine agonist for treating hyperprolactinemia, is also used off-label for treating acromegaly. Cabergoline monotherapy is reported to normalize IGF-I levels in more than one-third of patients with acromegaly. When a somatostatin receptor ligand proves ineffective, cabergoline add-on therapy normalizes the IGF-I level in 40-50% of patients. Finally, when combined with the GH receptor antagonist pegvisomant in patients with mild uncontrolled disease, cabergoline helps to achieve normal IGF-I levels while avoiding the need for high-dose pegvisomant. Cabergoline is also inexpensive and well tolerated; in particular, it does not appear to promote heart valve disease.
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre Service d'Endocrinologie et des Maladies de la Reproduction, 78 rue du Général Leclerc, 94275, Le Kremlin-Bicêtre, France.|Faculté de Médecine Paris-Sud, Université Paris-Sud, Orsay, France.|Unité Mixte de Recherche-S1185, 94276, Le Kremlin Bicêtre, France.|Institut National de la Santé et de la Recherche Médicale (INSERM) U1185, 94276, Le Kremlin Bicêtre, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Kuhn
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre Service d'Endocrinologie et des Maladies de la Reproduction, 78 rue du Général Leclerc, 94275, Le Kremlin-Bicêtre, France. philippe.chanson@bct.aphp.fr.|Faculté de Médecine Paris-Sud, Université Paris-Sud, Orsay, France. philippe.chanson@bct.aphp.fr.|Unité Mixte de Recherche-S1185, 94276, Le Kremlin Bicêtre, France. philippe.chanson@bct.aphp.fr.|Institut National de la Santé et de la Recherche Médicale (INSERM) U1185, 94276, Le Kremlin Bicêtre, France. philippe.chanson@bct.aphp.fr.
authors.forename: Philippe
authors.identifier: http://orcid.org/0000-0001-5096-5722
authors.initials: P
authors.lastname: Chanson
mesh_terms: D000172:Acromegaly / Q000188:drug therapy* / Q000378:metabolism; D000077465:Cabergoline; D018491:Dopamine Agonists / Q000627:therapeutic use; D004873:Ergolines / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D010911:Pituitary Neoplasms / Q000188:drug therapy / Q000378:metabolism; D017481:Receptors, Somatostatin / Q000819:agonists / Q000378:metabolism
chemical_list: D018491:Dopamine Agonists; D004873:Ergolines; D017481:Receptors, Somatostatin; D019382:Human Growth Hormone; D000077465:Cabergoline; C406545:pegvisomant
keywords: Acromegaly; Cabergoline; Pegvisomant; Pituitary adenoma; Somatostatin analogues