Long term therapy of patients with macroprolactinoma using repeatable injectable bromocriptine

Area of Science:

• Endocrinology
• Pharmacology

Background:

• Macroprolactinoma is a significant cause of hyperprolactinemia.
• Effective long-term management of macroprolactinoma is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the long-term efficacy and tolerability of injectable bromocriptine (Parlodel LAR) in patients with macroprolactinoma.

Main Methods:

• A cohort of 13 patients with macroprolactinoma received monthly intramuscular injections of Parlodel LAR.
• Dosing was adjusted based on prolactin (PRL) levels and patient tolerability, ranging from 50 mg to 250 mg per month.
• Tumor size, hormonal levels, and clinical symptoms were monitored over a mean treatment duration of 36 months.

Main Results:

• Normal PRL levels were achieved in 9 out of 13 patients, with significant PRL reduction in the remaining patients.
• Tumor shrinkage (23-100%) was observed in 12 patients.
• Improvements in hormonal symptoms (menses, libido, potency, galactorrhea) and visual fields were noted.
• Mild to moderate side effects, primarily gastrointestinal, occurred in 6 patients, mostly transient.

Conclusions:

• Injectable bromocriptine (Parlodel LAR) is an effective and well-tolerated long-term treatment option for macroprolactinoma.
• Monthly administration of Parlodel LAR demonstrates significant efficacy in normalizing PRL levels and reducing tumor burden.
• The treatment offers substantial clinical benefits for hormonal disturbances and mass effects associated with macroprolactinoma.