Prospective Study of High-Dose Cabergoline Treatment of Prolactinomas in 150 Patients

Context: Cabergoline fails to normalize hyperprolactinemia in a considerable proportion of prolactinomas, especially macroadenomas. Objective: We examined the effect of individualized high-dose cabergoline treatment on hyperprolactinemia in prolactinomas. Patients: The study included 122 women and 28 men (93 microadenomas and 57 macroadenomas). Forty-seven had undergone transsphenoidal surgery. According to the preceding medical treatment, the participants were separated into untreated (group U; n = 60), intolerant (group I; n = 64), and resistant (group R; n = 26) groups. Interventions: We promptly increased cabergoline dose on the basis of individual prolactin levels. Length of treatment was 1 yr. Results: Cabergoline normalized hyperprolactinemia in all patients except one. The proportion of prolactin normalization in both groups U and I was 83% at 3 months and 95% at 6 months. By contrast, that in group R was 35% at 3 months and 58% at 6 months. Mean cabergoline dose in milligrams per week at the time...