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Cabergoline Withdrawal Before and After Menopause: Outcomes in Microprolactinomas
Rita Indirli1,2, Emanuele Ferrante3, Elisa Sala2
1Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Hormones & Cancer
|April 20, 2019
Summary
Postmenopausal women with microprolactinoma had a lower recurrence rate after stopping cabergoline treatment compared to premenopausal women. However, menopausal status alone does not guarantee long-term remission, necessitating continued follow-up.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Oncology
Background:
- Prolactinomas are pituitary tumors that secrete prolactin.
- The natural course of prolactinomas after menopause is not well understood.
- Cabergoline is a dopamine agonist used to treat prolactinomas.
Purpose of the Study:
- To compare the recurrence rate of microprolactinomas after cabergoline withdrawal in premenopausal versus postmenopausal women.
- To identify factors influencing recurrence risk after treatment cessation.
Main Methods:
- Retrospective study of 62 women with microprolactinoma treated with cabergoline for at least one year.
- Patients were divided into premenopausal (PRE) and postmenopausal (POST) groups based on menopausal status at drug withdrawal.
- Follow-up was conducted for two years post-withdrawal, with recurrence defined by elevated prolactin levels confirmed on two occasions.
Main Results:
- Overall, 39 out of 62 women (63%) relapsed after cabergoline withdrawal.
- The recurrence rate was significantly lower in postmenopausal women (29%) compared to premenopausal women (73%) (p < 0.005).
- Higher prolactin levels before withdrawal were associated with relapse, but multivariate analysis showed no significant correlation between recurrence risk and menopausal status, prolactin levels, treatment duration, or adenoma regression.
Conclusions:
- Postmenopausal status may be associated with a lower risk of prolactinoma recurrence after cabergoline withdrawal, but it cannot reliably predict long-term remission.
- Continued monitoring and follow-up are essential for all women, regardless of menopausal status, after discontinuing cabergoline treatment for microprolactinoma.
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