Prospective, long-term study of the effect of cabergoline on valvular status in patients with prolactinoma and idiopathic hyperprolactinemia

Endocrine. 2017 Jan;55(1):239-245. doi: 10.1007/s12020-016-1120-5. Epub 2016 Oct 5.

Abstract

Since the 1990's cabergoline has been the treatment of choice in prolactinoma, as it permits rapid and effective hormonal and tumor control in most cases. Evidence of cardiac valvulopathy was demonstrated in Parkinson's disease patients treated with dopamine agonists. Retrospective studies in prolactinoma patients treated with cabergoline at lower doses did not show such an effect. However, few prospective data with long-term follow-up are available. The aim of this study was to assess the safety of cabergoline regarding cardiac valvular status during prospective follow-up in patients treated for prolactinoma or idiopathic hyperprolactinemia. We report here a series of 100 patients (71F; median age at diagnosis: 41.5 years) treated with cabergoline for endocrine diseases (prolactinoma n = 89, idiopathic hyperprolactinemia n = 11). All patients underwent complete transthoracic echocardiographic studies at baseline and during long-term prospective surveillance using the same equipment and performed by the same technicians. The median interval between baseline and last follow-up echocardiographic studies while on cabergoline was 62.5 months (interquartile range: 34.75-77.0). The median total duration of cabergoline treatment was 124.5 months (interquartile range: 80.75-188.75) and the median cumulative total dose of cabergoline was 277.8 mg (interquartile range : 121.4-437.8 mg) at last follow-up. We found no clinically relevant alterations in cardiac valve function or valvular calcifications with cabergoline treatment. Our data suggest that findings from retrospective analyses are correct and that cabergoline is a safe chronic treatment at the doses used typically in endocrinology.

Keywords: Cabergoline; Cardiac valve; Echocardiography; Hyperprolactinemia; Prolactinoma.

MeSH terms

  • Adult
  • Cabergoline
  • Dopamine Agonists / pharmacology
  • Dopamine Agonists / therapeutic use*
  • Echocardiography
  • Ergolines / pharmacology
  • Ergolines / therapeutic use*
  • Female
  • Heart Valve Diseases / diagnostic imaging
  • Heart Valves / diagnostic imaging
  • Heart Valves / drug effects*
  • Humans
  • Hyperprolactinemia / drug therapy*
  • Hyperprolactinemia / etiology
  • Male
  • Middle Aged
  • Pituitary Neoplasms / drug therapy*
  • Prolactinoma / complications
  • Prolactinoma / drug therapy*
  • Prospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Dopamine Agonists
  • Ergolines
  • Cabergoline