Lukas Andereggen1,2, Janine Frey3, Emanuel Christ4. 1. Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster Inselspital, Bern University Hospital, Bern, Switzerland. lukas.andereggen@gmail.com. 2. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland. lukas.andereggen@gmail.com. 3. Department of Gynecology and Obstetrics, Kantonsspital Lucerne, Lucerne, Switzerland. 4. Department of Endocrinology, Diabetology and Metabolism, University Hospital of Basel, Basel, Switzerland.
Abstract
PURPOSE: Cabergoline (CAB) therapy for prolactinomas has been associated with serum IGF-1 levels modifications, with recent reports indicating a paradoxical increase of IGF-1 levels during ongoing therapy. As a result, IGF-1 measurement has been proposed not only at diagnosis of a prolactinoma, but also during follow-up. In this follow-up study on prolactinoma patients with chronic CAB therapy, we investigated whether there are long-term changes in IGF-1 levels that necessitate continuous monitoring. METHODS: We reviewed our institutional database on prolactinoma patients with long-term CAB therapy, in whom IGF-1 levels were measured at baseline, at 3-months follow-up and in the long term. RESULTS: Chronic CAB therapy was noted in 20 patients (13 men, 7 women). Median (±SD) age was 43.5 ± 12.6 years. 17 (85%) patients presented with a macroprolactinoma. Median CAB treatment time was 75 ± 43 months (range 24-187). Median IGF-1 levels increased at last follow-up, though not significantly; from 122 ± 37 ng/ml (IQR 104-160 ng/ml) to 133 ± 54 (IQR 121-162 ng/ml), p = 0.10. Thereby, 18 (90%) patients showed normal serum IGF-1 levels adjusted for age, one (5%) patient above (1.05 × ULN) and 1 (5%) patient below the normal range (0.34 × ULN). No patient was or became symptomatic of acromegaly. CONCLUSION: Our long-term results indicate that chronic treatment with CAB in prolactinoma patients does not significantly modify serum IGF-1 levels. Bearing in mind the sample size of this study, continuing IGF-1 monitoring is not indicated in prolactinoma patients with long-term CAB therapy.
PURPOSE:Cabergoline (CAB) therapy for prolactinomas has been associated with serum IGF-1 levels modifications, with recent reports indicating a paradoxical increase of IGF-1 levels during ongoing therapy. As a result, IGF-1 measurement has been proposed not only at diagnosis of a prolactinoma, but also during follow-up. In this follow-up study on prolactinomapatients with chronic CAB therapy, we investigated whether there are long-term changes in IGF-1 levels that necessitate continuous monitoring. METHODS: We reviewed our institutional database on prolactinomapatients with long-term CAB therapy, in whom IGF-1 levels were measured at baseline, at 3-months follow-up and in the long term. RESULTS: Chronic CAB therapy was noted in 20 patients (13 men, 7 women). Median (±SD) age was 43.5 ± 12.6 years. 17 (85%) patients presented with a macroprolactinoma. Median CAB treatment time was 75 ± 43 months (range 24-187). Median IGF-1 levels increased at last follow-up, though not significantly; from 122 ± 37 ng/ml (IQR 104-160 ng/ml) to 133 ± 54 (IQR 121-162 ng/ml), p = 0.10. Thereby, 18 (90%) patients showed normal serum IGF-1 levels adjusted for age, one (5%) patient above (1.05 × ULN) and 1 (5%) patient below the normal range (0.34 × ULN). No patient was or became symptomatic of acromegaly. CONCLUSION: Our long-term results indicate that chronic treatment with CAB in prolactinomapatients does not significantly modify serum IGF-1 levels. Bearing in mind the sample size of this study, continuing IGF-1 monitoring is not indicated in prolactinomapatients with long-term CAB therapy.
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Authors: Lukas Andereggen; Janine Frey; Robert H Andres; Markus M Luedi; Jan Gralla; Gerrit A Schubert; Jürgen Beck; Luigi Mariani; Emanuel Christ Journal: J Clin Transl Endocrinol Date: 2021-06-17
Authors: Lukas Andereggen; Janine Frey; Robert H Andres; Markus M Luedi; Hans Rudolf Widmer; Jürgen Beck; Luigi Mariani; Emanuel Christ Journal: Sci Rep Date: 2021-03-04 Impact factor: 4.379
Authors: Markus Huber; Markus M Luedi; Gerrit A Schubert; Christian Musahl; Angelo Tortora; Janine Frey; Jürgen Beck; Luigi Mariani; Emanuel Christ; Lukas Andereggen Journal: Front Endocrinol (Lausanne) Date: 2022-02-16 Impact factor: 5.555
Authors: L Andereggen; J Frey; R H Andres; M M Luedi; M El-Koussy; H R Widmer; J Beck; L Mariani; R W Seiler; E Christ Journal: J Endocrinol Invest Date: 2021-04-13 Impact factor: 4.256