Abstract
Cabergoline and quinagolide, two new dopamine agonist drugs with long-lasting activity, are currently under investigation for the treatment of hyperprolactinemia. At present, studies comparing these drugs for tolerability and efficacy in the same patients are lacking. It was our aim to make such a comparison in an open randomized cross-over trial. Cabergoline (0.5 mg twice weekly) and quinagolide (75 µg once daily) were given orally. Each drug was administered for 12 weeks. Treatment with the second drug was started after the recurrence of hyperprolactinemia. Twelve women with hyperprolactinemia due to idiopathic disease (n=6), microprolactinoma (n=5) or postsurgical empty sella (n=1) were evaluated. Six women were amenorrheic and 6 were oligomenorrheic. Ten had spontaneous or provoked galactorrhea. Baseline characteristics (age, clinical signs and PRL levels) of patients initially allocated to the two treatment groups were similar. Nine patients completed both treatment cycles and PRL levels were lower under cabergoline (10.7±3.7 µg/L) than under quinagolide (25.0±7.7 µg/L; p<0.05). One patient discontinued cabergoline because of dryness of the eyes after having completed the quinagolide cycle and 2 patients initially treated with cabergoline discontinued quinagolide because of gastrointestinal symptoms. After completion of the first treatment cycle, the time of recurrence of hyperprolactinemia was significantly longer after cabergoline (14±7 weeks) than after quinagolide (5±1 weeks; p<0.05). At week 12, normal PRL levels (<20 µg/L) were observed in 10 and 6 women during cabergoline and quinagolide, respectively. Only one case was resistant to both drugs. The clinical effects of the two treatments were similar. At week 12, minor side effects were described in 5 and 9 women on cabergoline and quinagolide. The number of patients without side effects was significantly higher after cabergoline (n=6) than after quinagolide (n=1; p<0.01). Our study indicates that, at the doses employed, cabergoline shows a better long-lasting efficacy and tolerability than quinagolide. Drop-outs due to severe side effects occurred with both drugs. However, quinagolide could be regarded as a further choice in the medical management of hyperprolactinemia.
Article PDF
Similar content being viewed by others
Explore related subjects
Discover the latest articles and news from researchers in related subjects, suggested using machine learning.Avoid common mistakes on your manuscript.
References
Blackwell R.E. Hyperprolactinemia evaluation and management. Endocrinol. Metab. Clin. 21: 105, 1992.
Molitch M.E. Management of prolactinomas. Ann. Rev. Med. 40: 225, 1989.
Benker G., Gieshoff B., Freundieb O., Windeck R., Schulte H.M., Lancranjan I., Reinwein D. Parenteral bromocriptine in the treatment of hormonally active pituitary tumours. Clin. Endocrinol (Oxf.) 24: 505, 1986.
Gianola D., Pedroncelli A., Montini M., Tengattini F., Pagani M.C.Cortesi L, Cappi M.P., Gherardi F., Lancranjan I., Pagani G. A new oral slow release form of bromocriptine, Parlodel SRO, in the chronic treatment of 26 hyperprolactinemic patients. Gynecol. Endocrinol. 5: 213, 1991.
Lamberts S.W.S., Quick R.F. A comparison of the efficacy and safety of pergolide and bromocriptine in the treatment of hyperprolactinemia. J. Clin. Endocrinol. Metab. 72: 635, 1991.
Ciccarelli E., Giusti M., Miola C., Potenzoni F., Sghedoni D., Camanni F., Giordano G. Effectiveness and tolerability of long term treatment with cabergoline, a new long-lasting ergoline derivative, in hyperprolactinemic patients. J. Clin. Endocrinol. Metab. 69: 725, 1989.
Ferrari C, Mattei A.M., Melis G.B., Paracchi A., Muratori M., Faglia G., Sghedoni D., Crosignani P.G. Cabergoline: long-acting oral treatment of hyperprolactinemic disorders. J. Clin. Endocrinol. Metab. 68: 1201, 1989.
Ferrari C., Paracchi A., Mattei A.M., De Vincentis S., D’AIberton A., Crosignani P.G. Cabergoline in the long-term therapy of hyperprolactinemic disorders. Acta Endocrinol. (Copenh.) 126: 489, 1992.
Webster J., Piscitelli G., Polli A., D’AIberton A., Falsetti L., Ferrari C, Fioretti P., Giordano G., L’Hermite M., Ciccarelli E., Crosignani P.G., De Cecco L., Fadini R., Faglia G., Flamigni F., Tamburrano G., Scanion M.F. Dose-dependent suppression of serum prolactin by cabergoline in hyperprolactinaemia: a placebo controlled, double blind, multicentre study. Clin. Endocrinol. (Oxf.) 37: 534, 1992.
Homburg R., West C., Brownell J., Jacobs H.S. A double-blind study comparing a new non-ergot, long-acting dopamine agonist, CV 205–502, with bromocriptine in women with hyperprolactinaemia. Clin. Endocrinol. (Oxf.) 32: 565, 1990.
Newman C.B., Hurley A.M., Kleinberg D.L. Effects of CV 205–502 in hyperprolactinaemic patients intolerant of bromocriptine. Clin. Endocrinol. (Oxf.) 31: 391, 1989.
Rasmussen C, Bergh T., Wide L, Brownell J. Long-term treatment with a non-ergot long-acting dopamine agonist CV 205–502, in women with hyperprolactinaemia. Clin. Endocrinol. (Oxf.) 29: 271, 1988.
Rasmussen C., Brownell J., Bergh T. Clinical response and prolactin concentration in hyperprolactinemic women during and after treatment for 24 months with the new dopamine agonist, CV 205–502. Acta Endocrinol. (Copenh.) 125: 170, 1991.
Vance M.L., Cragun J.R., Reimnitz C., Chang R.J., Rashef E., Blackwell R.E., Miller M.M., Molitch M.E. CV 205–502 treatment of hyperprolactinemia. J. Clin. Endocrinol. Metab. 66: 336, 1989.
Van der Heijden P.P., De Wit W., Brownell J., Schoemaker J., Rolland R. CV 205–502, a new dopamine agonist, versus bromocriptine in the treatment of hyperprolactinaemia. Eur. J. Obstet. Gynecol. Reprod. Biol. 46: 111, 1991.
Verhelst J.A., Froud A.L., Touzel R., Wass J.A.H., Besser G.M., Grossman A.B. Acute and long-term effects of once-daily oral bromocriptine and a new long acting non ergot dopamine agonist, quinagolide, in the treatment of hyperprolactinemia: a double-blind study. Acta Endocrinol. (Copenh.) 125: 385, 1991.
Giusti M., Durante M., Cavagnaro P., Sghedoni D., Giordano G. Two years of experience using cabergoline in the treatment of women with pathological hyperprolactinaemia. In: Genazzani A.R., Petraglia F., Volpe A. (Eds.), Research Reports on Gynecology and Obstetrics. Parthenon Publishing Group, Carnforth, vol. 2, 1990, p. 190.
Vance M.L., Evans W.S., Thorner M.O. Bromocriptine. Ann. Intern. Med. 100: 78, 1984.
Ciccarelli E., Mazza E., Ghigo E., Guidoni F., Barberis A., Massara F., Camanni F. Long term treatment with oral single administration of bromocriptine in patients with hyperprolactinemia. J. Endocrinol. Invest. 10: 51, 1987.
Brue T., Pellegrini I., Gunz G., Morange I., Dewailly D., Brownell J., Enjalbert A., Jaquet P. Effects of the dopamine agonist CV 205–502 in human prolactinomas resistant to bromocriptine. J. Clin. Endocrinol. Metab. 74: 577, 1992.
Vance M.L, Upper M., KIibanski A., Biller B.M.K., Samaan N.A., Molitch M.E. Treatment of prolactin-secreting pituitary macroadenomas with the long-acting non ergot dopamine agonist CV 205–502. Ann. Intern. Med. 112: 668, 1990.
Di Salle E., Ornati G., Giudici D. A comparison of the in vivo and in vitro duration of prolactin lowering effects in rats of FCE 21226, pergolide and bromocriptine. J. Endocrinol. Invest. 7(Suppl. 1): 32, 1984.
Fluckiger E. Pharmacological profile of dopaminergic agents. In: Molinatti G.M., Martini L. (Eds.), Endocrinology. Elsevier Science Publishers, Amsterdam, 1986, p. 261.
Barnett P.S., Palazidou E., Miell J.P., Coskeran P.B., Butler J., Dawson J.M., Maccabe J., McGregor A.M. Endocrine function, psychiatric and clinical consequences in patients with macroprolactinomas after long-term treatment with the new non-ergot dopamine agonist CV 205–502. Quart. J. Med. 81: 891, 1991.
Khalfallah Y., Claustrat B., Grochowicki M., Flocard F., Horlait S., Serusclat P., Sassolas G. Effects of a new prolactin inhibitor, CV 205–502, in the treatment of human prolactinomas. J. Clin. Endocrinol. Metab. 71: 354, 1990.
Sassolas G., Khalfallah Y., Trouillas J. CV 205–502, new prolactin inhibitor, prevents tumour development and induces tumor reduction in an animal model and in human prolactinoma. In: Besser G.M., Lamberts S.W.J. (Eds.), CV 205–502: 1st International Round Table Conference. Medicom, Europe, 1990, p. 71.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Giusti, M., Porcella, E., Carraro, A. et al. A cross-over study with the two novel dopaminergic drugs cabergoline and quinagolide in hyperprolactinemic patients. J Endocrinol Invest 17, 51–57 (1994). https://doi.org/10.1007/BF03344963
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03344963