Efficacy of cabergoline use in patients with Acromegaly

We aimed to analyze the effectiveness of cabergoline in acromegaly treatment. Demographic characteristics, blood hormone levels, characteristics of MR imaging, and the pathology results of 56 patients with cabergoline use were analyzed retrospectively. After 6 months of cabergoline use, patients with normal IGF-1(Insulin-like growth factor-1) and GH levels less than 1,0 ng/L are considered as the 'controlled disease' group. Patients who did not meet these criteria with high hormone levels, who needed to add another medication to their current treatment, who needed increased doses of other medications besides cabergoline, or who went through transsphenoidal surgery during follow-up were considered as the 'uncontrolled disease' group. The data of these two groups were compared. In our study, disease control was achieved at a rate of 42,9% by adding cabergoline to the treatment in patients with acromegaly. Cabergoline normalised the hormone levels %28,6 of the patients when used as first medication, %44,7 when used as second medication, and %75 when used as third medication. The IGF-1 levels, estimated IGF-1% value and GH levels before cabergoline were significantly lower in the controlled disease group compared to uncontrolled disease group (respectively p=0,023, p=0,009 and p=0,002). Cabergolin levels at the time of diagnosis of the patients of the controlled disease group were higher than uncontrolled disease group (p=0.26). Our study showed that cabergoline is more effective especially in patients with moderate GH and IGF-1 elevations before cabergoline treatment and in patients with higher GH levels at the time of diagnosis. Cabergoline may be an effective treatment option when used in patients who have higher GH levels at the time of diagnosis, moderate IGF-1 and GH levels before cabergoline treatment, and especially when used in combination therapy as the second or third agent. Keywords: Cabergoline, Acromegaly, Pituitary gland, IGF-1