Effect of the new dopaminergic agonist CV 205-502 on plasma prolactin levels and tumour size in bromocriptine-resistant prolactinomas

Clin Endocrinol (Oxf). 1991 Jan;34(1):25-9. doi: 10.1111/j.1365-2265.1991.tb01731.x.

Abstract

Bromocriptine is currently and successfully used for the treatment of pituitary prolactinomas. However, bromocriptine appears unable to normalize plasma prolactin levels in about 10% and to reduce tumour size in one-third of cases. The lack of normalization of plasma prolactin levels in spite of a daily dose of bromocriptine equal to or higher than 15 mg suggests a bromocriptine resistance. We compared the long-term effects of bromocriptine and CV 205-502 (a non-ergot derivative D2 dopamine agonist) on plasma prolactin levels and tumour size in seven bromocriptine-resistant prolactinomas. Bromocriptine reduced significantly (P less than 0.001) plasma prolactin levels (from 2307 +/- 518 to 568 +/- 279 micrograms/l) (conversion to Sl units: 1 microgram/l = 20 mU/l). Visual field defects observed in five patients improved in four. However, CT scan analysis showed a decrease in tumour size in only three patients. Except for transient and minor side-effects at the beginning of the treatment, CV 205-502 was well tolerated in five of seven patients. In the remaining two patients nausea and vertigo occurred with high dosages of CV 205-502 and it was necessary to reduce the daily dose. CV 205-502 lowered plasma prolactin to levels similar to those obtained after bromocriptine therapy in four cases. In the three remaining patients, CV 205-502 was more potent than bromocriptine as demonstrated by the further 90% reduction in plasma levels obtained in one case and by the normalization of plasma prolactin levels in the two other cases. One woman became pregnant during CV 205-502 treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aminoquinolines / therapeutic use*
  • Bromocriptine / therapeutic use
  • Dopamine Agents / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pituitary Neoplasms / blood
  • Pituitary Neoplasms / drug therapy*
  • Pituitary Neoplasms / pathology
  • Prolactin / blood*
  • Prolactinoma / blood
  • Prolactinoma / drug therapy*
  • Prolactinoma / pathology
  • Prospective Studies
  • Retrospective Studies

Substances

  • Aminoquinolines
  • Dopamine Agents
  • Bromocriptine
  • quinagolide
  • Prolactin