Dopamine agonists were the fi rst eff ective medical treatment for pituitary adenomas. The general effi cacy of this treatment was associated with the general notion of doctors that the treatment of prolactinomas is straightforward and merely consists of prescribing dopamine agonists. Consequently, these patients are treated by diff erent sorts of specialists including internists, endocrinologists, pediatricians, and gynecologists. However, the studies documented in this thesis prove that the treatment of this disease is not simple in all respects.
Even in the case of microprolactinomas, with an adequate response to dopamine agonists, patients may be dissatisfi ed with the treatment of the doctor, because they suff er from a con- siderable decrease in perceived quality of life parameters. This dissatisfaction may adversely aff ect patient-doctor relationships.
Long-term treatment of macroprolactinomas is not straightforward in case there is resistance or intolerance to dopamine agonists. In these situations, therapy may be switched to another dopamine agonist. In case this switch is unsuccessful, surgical treatment is a second line option. In individual cases a choice may be made for additional postoperative radiotherapy. The second and third line treatments are associated with a much higher incidence of hypopituitarism, and therefore the choice for these treatment modalities may further impair quality of life.
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Long-term treatment of prolactinomas is associated with an increased prevalence of mild tricuspid regurgitation and calcifi cation of the aortic valve in the absence of increased clinically relevant valve regurgitation. The clinical relevance of this observation is presently unclear, but this observation should not be taken too lightly. For instance, during long-term treatment of macroprolactinomas only 22% of the patients were cured, whereas the other patients required prolongation of dopamine agonist therapy, which ultimately may potentially adversely aff ect valvular functions.
Finally, in extremely rare situations the clinical course of a prolactinoma may be more com- plicated and aggressive which should alert the physician on the possibility of the existence of a malignant prolactinoma.
The studies presented in the current thesis indicate that dedicated care is required for all patients with prolactinomas.
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REFERENCES
1. Molitch ME, Elton RL, Blackwell RE et al. Bromocriptine as primary therapy for prolactin-secreting macroadenomas: results of a prospective multicenter study. J Clin Endocrinol Metab 1985; 60(4):698-705.
2. Van ‘t Verlaat JW, Croughs RJ, Hendriks MJ, Bosma NJ. Results of primary treatment with bromocriptine of prolactinomas with extrasellar extension. Can J Neurol Sci 1990; 17(1):71-73.
3. Van ‘t Verlaat JW, Croughs RJ, Brownell J. Treatment of macroprolactinomas with a new non-ergot, long-acting dopaminergic drug, CV 205-502. Clin Endocrinol (Oxf ) 1990; 33(5):619-624.
4. Ferrari C, Paracchi A, Mattei AM, de VS, D’Alberton A, Crosignani P. Cabergoline in the long-term therapy of hyperprolactinemic disorders. Acta Endocrinol (Copenh) 1992; 126(6):489-494.
5. Webster J, Piscitelli G, Polli A, Ferrari CI, Ismail I, Scanlon MF. A comparison of cabergoline and bro- mocriptine in the treatment of hyperprolactinemic amenorrhea. Cabergoline Comparative Study Group. N Engl J Med 1994; 331(14):904-909.
6. Verhelst J, Abs R, Maiter D et al. Cabergoline in the treatment of hyperprolactinemia: a study in 455 patients. J Clin Endocrinol Metab 1999; 84(7):2518-2522.
7. Verhelst J, Abs R. Hyperprolactinemia: pathophysiology and management. Treat Endocrinol 2003; 2(1):23-32.
8. Schultz PN, Ginsberg L, McCutcheon IE, Samaan N, Leavens M, Gagel RF. Quinagolide in the manage- ment of prolactinoma. Pituitary 2000; 3(4):239-249.
9. Di Sarno A, Landi ML, Marzullo P et al. The eff ect of quinagolide and cabergoline, two selective dopamine receptor type 2 agonists, in the treatment of prolactinomas. Clin Endocrinol (Oxf ) 2000; 53(1):53-60.
10. Colao A, De Rosa M, Sarnacchiaro F et al. Chronic treatment with CV 205-502 restores the gonadal function in hyperprolactinemic males. Eur J Endocrinol 1996; 135(5):548-552.
11. Colao A, Di Sarno A, Landi ML et al. Long-term and low-dose treatment with cabergoline induces macroprolactinoma shrinkage. J Clin Endocrinol Metab 1997; 82(11):3574-3579.
12. Colao A, Di Sarno A, Landi ML et al. Macroprolactinoma shrinkage during cabergoline treatment is greater in naive patients than in patients pretreated with other dopamine agonists: a prospective study in 110 patients. J Clin Endocrinol Metab 2000; 85(6):2247-2252.
13. Colao A, Vitale G, Cappabianca P et al. Outcome of cabergoline treatment in men with prolactinoma: eff ects of a 24-month treatment on prolactin levels, tumor mass, recovery of pituitary function, and semen analysis. J Clin Endocrinol Metab 2004; 89(4):1704-1711.
14. Passos VQ, Souza JJ, Musolino NR, Bronstein MD. Long-term follow-up of prolactinomas: normopro- lactinemia after bromocriptine withdrawal. J Clin Endocrinol Metab 2002; 87(8):3578-3582. 15. Chattopadhyay A, Bhansali A, Masoodi SR. Long-term effi cacy of bromocriptine in macroprolactino-
mas and giant prolactinomas in men. Pituitary 2005; 8(2):147-154.
16. Berinder K, Stackenas I, Akre O, Hirschberg AL, Hulting AL. Hyperprolactinaemia in 271 women: up to three decades of clinical follow-up. Clin Endocrinol (Oxf ) 2005; 63(4):450-455.
17. Wu ZB, Yu CJ, Su ZP, Zhuge QC, Wu JS, Zheng WM. Bromocriptine treatment of invasive giant prolactinomas involving the cavernous sinus: results of a long-term follow up. J Neurosurg 2006; 104(1):54-61.
18. Hamilton DK, Vance ML, Boulos PT, Laws ER. Surgical outcomes in hyporesponsive prolactinomas: analysis of patients with resistance or intolerance to dopamine agonists. Pituitary 2005; 8(1):53-60. 19. Losa M, Mortini P, Barzaghi R, Gioia L, Giovanelli M. Surgical treatment of prolactin-secreting pituitary
adenomas: early results and long-term outcome. J Clin Endocrinol Metab 2002; 87(7):3180-3186. 20. Webster J. A comparative review of the tolerability profi les of dopamine agonists in the treatment of
hyperprolactinaemia and inhibition of lactation. Drug Saf 1996; 14(4):228-238.
Marleen BW.indd 123
Chapt
er 7
124
21. Di Sarno A, Landi ML, Cappabianca P et al. Resistance to cabergoline as compared with bromocriptine in hyperprolactinemia: prevalence, clinical defi nition, and therapeutic strategy. J Clin Endocrinol Metab 2001; 86(11):5256-5261.
22. Molitch ME. Pharmacologic resistance in prolactinoma patients. Pituitary 2005; 8(1):43-52.
23. Biermasz NR, Dekker FW, Pereira AM et al. Determinants of survival in treated acromegaly in a single center: predictive value of serial insulin-like growth factor I measurements. J Clin Endocrinol Metab 2004; 89(6):2789-2796.
24. Dekkers OM, Biermasz NR, Pereira AM et al. Mortality in patients treated for Cushing’s disease is increased, compared with patients treated for nonfunctioning pituitary macroadenoma. J Clin Endo- crinol Metab 2007; 92(3):976-981.
25. Freda PU, Katznelson L, van der Lely AJ, Reyes CM, Zhao S, Rabinowitz D. Long-acting somatostatin analog therapy of acromegaly: a meta-analysis. J Clin Endocrinol Metab 2005; 90(8):4465-4473. 26. Pritchett AM, Morrison JF, Edwards WD, Schaff HV, Connolly HM, Espinosa RE. Valvular heart disease in
patients taking pergolide. Mayo Clin Proc 2002; 77(12):1280-1286.
27. Van Camp G, Flamez A, Cosyns B, Goldstein J, Perdaens C, Schoors D. Heart valvular disease in patients with Parkinson’s disease treated with high-dose pergolide. Neurology 2003; 61(6):859-861.
28. Van Camp G, Flamez A, Cosyns B et al. Treatment of Parkinson’s disease with pergolide and relation to restrictive valvular heart disease. Lancet 2004; 363(9416):1179-1183.
29. Baseman DG, O’Suilleabhain PE, Reimold SC, Laskar SR, Baseman JG, Dewey RB, Jr. Pergolide use in Parkinson disease is associated with cardiac valve regurgitation. Neurology 2004; 63(2):301-304. 30. Yamamoto M, Uesugi T, Nakayama T. Dopamine agonists and cardiac valvulopathy in Parkinson
disease: a case-control study. Neurology 2006; 67(7):1225-1229.
31. Zanettini R, Antonini A, Gatto G, Gentile R, Tesei S, Pezzoli G. Valvular heart disease and the use of dopamine agonists for Parkinson’s disease. N Engl J Med 2007; 356(1):39-46.
32. Schade R, Andersohn F, Suissa S, Haverkamp W, Garbe E. Dopamine agonists and the risk of cardiac- valve regurgitation. N Engl J Med 2007; 356(1):29-38.
33. Redfi eld MM, Nicholson WJ, Edwards WD, Tajik AJ. Valve disease associated with ergot alkaloid use: echocardiographic and pathologic correlations. Ann Intern Med 1992; 117(1):50-52.
34. Connolly HM, Crary JL, McGoon MD et al. Valvular heart disease associated with fenfl uramine- phentermine. N Engl J Med 1997; 337(9):581-588.
35. Rothman RB, Baumann MH, Savage JE et al. Evidence for possible involvement of 5-HT(2B) recep- tors in the cardiac valvulopathy associated with fenfl uramine and other serotonergic medications. Circulation 2000; 102(23):2836-2841.
36. Jollis JG, Landolfo CK, Kisslo J, Constantine GD, Davis KD, Ryan T. Fenfl uramine and phentermine and cardiovascular fi ndings: eff ect of treatment duration on prevalence of valve abnormalities. Circula- tion 2000; 101(17):2071-2077.
37. Simula DV, Edwards WD, Tazelaar HD, Connolly HM, Schaff HV. Surgical pathology of carcinoid heart disease: a study of 139 valves from 75 patients spanning 20 years. Mayo Clin Proc 2002; 77(2):139-147.
38. Biermasz NR, van Thiel SW, Pereira AM et al. Decreased quality of life in patients with acromegaly despite long-term cure of growth hormone excess. J Clin Endocrinol Metab 2004; 89(11):5369-5376. 39. Van Aken MO, Pereira AM, Biermasz NR et al. Quality of life in patients after long-term biochemical
cure of Cushing’s disease. J Clin Endocrinol Metab 2005; 90(6):3279-3286.
40. Dekkers OM, van der Klaauw AA, Pereira AM et al. Quality of life is decreased after treatment for nonfunctioning pituitary macroadenoma. J Clin Endocrinol Metab 2006; 91(9):3364-3369.
41. Ciccarelli A, Daly AF, Beckers A. The epidemiology of prolactinomas. Pituitary 2005; 8(1):3-6. 42. Daly AF, Rixhon M, Adam C, Dempegioti A, Tichomirowa MA, Beckers A. High prevalence of pituitary
adenomas: a cross-sectional study in the province of Liege, Belgium. J Clin Endocrinol Metab 2006; 91(12):4769-4775.
43. Sobrinho LG. Emotional aspects of hyperprolactinemia. Psychother Psychosom 1998; 67(3):133-139.
Marleen BW.indd 124
44. Zhang A, Neumeyer JL, Baldessarini RJ. Recent progress in development of dopamine receptor subtype-selective agents: potential therapeutics for neurological and psychiatric disorders. Chem Rev 2007; 107(1):274-302.
45. Ben Jonathan N, Hnasko R. Dopamine as a prolactin (PRL) inhibitor. Endocr Rev 2001; 22(6):724-763. 46. Kaltsas GA, Grossman AB. Malignant pituitary tumours. Pituitary 1998; 1(1):69-81.
47. Kaltsas GA, Nomikos P, Kontogeorgos G, Buchfelder M, Grossman AB. Clinical review: Diagnosis and management of pituitary carcinomas. J Clin Endocrinol Metab 2005; 90(5):3089-3099.
Marleen BW.indd 125
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