اثربخشي و قابليت تحمل درمان با كابرگولين در بيماران مبتلا به هيپرپرولاكتينمي

Effectiveness and Tolerability of Treatment with Cabergoline in Hyperprolactinemic Patients

| Introduction: Cabergoline (CAB) is a new oral dopaminergic compound showing a very long-lasting PRL-lowering activity. The Purpose of this study is to evaluate the efficacy, side effect and tolerability of the treatment with CAB in female hyperprolactinemic patients. | Materials and methods: We conducted a cross-sectional study on hyperprolactinemic women. The patients under¬went the treatment with either Bromocriptine or Cabergoline over a period of 6 months. The initial dose of Cabergoline to be taken by the patients was 0.5 mg once a week and subsequently increased to 1-2 mg. per week. The initial prescribed dose of Bromocrip¬tine was 1.25 mg/d, which was subsequently increased to 7.5 mg/d. Then, throughout the study, the effectiveness and tolerability of the treatment with both Bromocriptine and Cabergoline were evaluated in the patients with hyperprolactinemia. | Results: Treatment with Bromocriptine normalized the serum PRL level (< 20 mcg/L) in 48% of the patients while in the Cabergoline group, the serum PRL level declined to normal in 77.7% of the patients. The comparison of the two groups showed that Cabergoline was significantly more effective than Bromocriptine in suppressing PRL secretion (P<0.001). The clinical efficacy of the drugs was clearly demonstrated by the resumption of menses in 68% and 83.3% of the patients in the Bromocriptine and Cabergoline groups, respec¬tively (PO.Ol). Six months after the therapy, a computed tomographic scan was performed on 15 patients with either microadenoma or macroadenoma. The results showed reduced size of the ad¬enoma in 33.3% and 55.5% of the patients in the Bromocriptine and Cabergoline groups, respectively (P<0.01). In the Cabergoline group, side effects were noted in 44.4% of the patients, but only 11.1% of them discontinued the therapy because of side effects. The comparison of the two groups showed that the number of patients requiring discontinuation of Bromocriptine was significantly higher (36% vs. 11.1%, P< 0.001). £ Conclusion: We conclude that CAB is an effective treatment for hyperprolactinemia and often better tolerated than Bromocriptine. Its efficacy, tolerability, and long duration of action make it the drug of choice for patients with hyperprolactinemia.