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Cabergoline versus bromocriptine for the treatment of giant prolactinomas: A quantitative and systematic review

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Abstract

The aim of this study is to compare the efficacy of bromocriptine (BRC) versus cabergoline (CAB) in patients with giant prolactinomas. We searched MEDLINE, EMBASE, CENTRAL and Clinical Trials.gov for studies dated before March 1st, 2016, that used BRC or CAB for the treatment of patients with giant prolactinomas. Specific eligibility criteria were set to identify articles and cases. The selected articles were reviewed, and the data were extracted for analysis. The compared outcomes included tumor shrinkage, tumor response, normalization of prolactin (PRL) level, and visual field defect (VFD) improvement. Gender differences were also considered. Differences between the groups were assessed using Student’s t test and the chi-square test. Two hundred and forty-five records were identified, and 10 articles and 104 cases met the inclusion criteria. Based on our analysis, CAB is significantly better than BRC in normalizing PRL levels in patients, especially males, with giant prolactinomas (69.4% versus 31.7%, p = 0.01). However, there was no significant difference between the two drugs in terms of tumor shrinkage, tumor response and VFD improvement (p > 0.05) in male or female patients. CAB exhibits significantly better efficacy than BRC in the normalization of PRL levels in male patients with giant prolactinomas. Regarding tumor reduction and VFD improvement, both drugs are comparably effective for patients of both genders. This quantitative and systematic review provides preliminary evidence in favor of CAB as a medical therapy for treating giant prolactinomas in male patients, especially those with extremely high PRL levels.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (81471392 and 81671371) and the Shanghai Municipal Education Commission Gaofeng Clinical Medicine Grant Support (20161407).

Funding

This work was supported by the National Natural Science Foundation of China (81471392 and 81671371) and the Shanghai Municipal Education Commission Gaofeng Clinical Medicine Grant Support (20161407).

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Authors and Affiliations

  1. Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197# Ruijin Er Road, Shanghai, 200025, China

    Hai Yan Huang

  2. Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197# Ruijin Er Road, Shanghai, 200025, China

    Shao Jian Lin, Wei Guo Zhao & Zhe Bao Wu

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  1. Hai Yan Huang
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  2. Shao Jian Lin
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Correspondence to Zhe Bao Wu.

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Huang, H.Y., Lin, S.J., Zhao, W.G. et al. Cabergoline versus bromocriptine for the treatment of giant prolactinomas: A quantitative and systematic review. Metab Brain Dis 33, 969–976 (2018). https://doi.org/10.1007/s11011-018-0217-3

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