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Dihydroergocriptine in management of microprolactinomas
G Faglia1, A Conti, M Muratori
1Department of Endocrinology, University of Milan School of Medicine, Italy.
The Journal of Clinical Endocrinology and Metabolism
|October 1, 1987
Summary
Dihydroergocriptine (DHECP) effectively lowers prolactin (PRL) levels in women with microprolactinomas, restoring reproductive function with fewer side effects than bromocriptine (BRC). Long-term DHECP treatment normalized PRL in most patients, with significant clinical improvements observed.
Area of Science:
- Endocrinology
- Pharmacology
- Reproductive Medicine
Background:
- Microprolactinomas are pituitary tumors that secrete prolactin (PRL).
- Current treatments like bromocriptine (BRC) can have significant side effects.
- Dihydroergocriptine (DHECP) is an ergot alkaloid with potential therapeutic applications.
Purpose of the Study:
- To evaluate the efficacy and safety of DHECP in treating women with PRL-secreting microprolactinomas.
- To compare DHECP's effects with those of BRC in a similar patient population.
Main Methods:
- Acute and long-term administration of DHECP (5 mg oral) in 22 women with microprolactinomas.
- Dose escalation of DHECP over 9 months, monitoring serum PRL levels.
- Comparison with historical data from 36 patients treated with BRC.
Main Results:
- Acute DHECP administration reduced serum PRL by 61%, with nadir at 300 min.
- Long-term DHECP treatment progressively lowered PRL, normalizing levels in 77% of patients.
- DHECP treatment restored menses, induced ovulation in 16 women, and resolved galactorrhea; side effects were negligible compared to BRC.
Conclusions:
- DHECP is an effective and well-tolerated treatment for microprolactinomas, comparable to BRC but with a superior side-effect profile.
- DHECP normalizes prolactin levels and restores reproductive function in a majority of treated women.
- Further research into DHECP's long-term effects and potential for adenoma resolution is warranted.