Efficacy and Cerebrospinal Fluid Rhinorrhea after Cabergoline Treatment in Patients with Bioactive Macroprolactinoma

Predicting dopamine agonist resistance in patients with macroprolactinoma is essential for clinicians to prevent treatment failure and subsequent complications such as medication-induced cerebrospinal fluid (CSF) rhinorrhea. We evaluated the features of patients with cabergoline resistance and CSF r...

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Autores principales:	Hae-Kyung Kim, Jae-Won Hong, Ju-Hyung Moon, Sung-Soo Ahn, Eui-Hyun Kim, Seung-Koo Lee, Eun-Jig Lee, Yae-Won Park, Cheol-Ryong Ku
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	cabergoline drug resistance cerebrospinal fluid rhinorrhea prolactinoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/e9510b45db974f3390a6d6e6d2b51516
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spelling	oai:doaj.org-article:e9510b45db974f3390a6d6e6d2b515162021-11-11T15:29:31ZEfficacy and Cerebrospinal Fluid Rhinorrhea after Cabergoline Treatment in Patients with Bioactive Macroprolactinoma10.3390/cancers132153742072-6694https://doaj.org/article/e9510b45db974f3390a6d6e6d2b515162021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5374https://doaj.org/toc/2072-6694Predicting dopamine agonist resistance in patients with macroprolactinoma is essential for clinicians to prevent treatment failure and subsequent complications such as medication-induced cerebrospinal fluid (CSF) rhinorrhea. We evaluated the features of patients with cabergoline resistance and CSF rhinorrhea in patients with prolactinomas with prolactin levels ≥1000 ng/mL. A total of 140 patients who were newly diagnosed with prolactinoma secreting only prolactin ≥1000 ng/mL and treated with cabergoline for the first time were included in this study. Based on the hormonal and radiologic response of the prolactinoma, the patients were divided into responders and non-responders. Non-responders (36/140, 25.8%) included a higher number of patients receiving hormone replacement than responders (responders, <i>n</i> (%) = 12(11.5) vs. non-responders = 13(36.1), <i>p</i> = 0.001). In propensity score matching analysis, patients who developed CSF rhinorrhea presented more frequent hormone deficiency than responders regardless of initial cabergoline dose. Hormone deficiency was associated with a greater odds ratio for the risk of non-responders (adjusted odds ratio = 5.13, 95% CI 1.96–13.46, <i>p</i> = 0.001). Cabergoline was effective in bioactive macroprolactinoma. Furthermore, initial cabergoline dose was not significantly associated with long-term responsiveness and development of CSF rhinorrhea but the hypopituitarism was independently associated with an increased risk of cabergoline resistance and CSF rhinorrhea.Hae-Kyung KimJae-Won HongJu-Hyung MoonSung-Soo AhnEui-Hyun KimSeung-Koo LeeEun-Jig LeeYae-Won ParkCheol-Ryong KuMDPI AGarticlecabergolinedrug resistancecerebrospinal fluid rhinorrheaprolactinomaNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5374, p 5374 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cabergoline drug resistance cerebrospinal fluid rhinorrhea prolactinoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	cabergoline drug resistance cerebrospinal fluid rhinorrhea prolactinoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Hae-Kyung Kim Jae-Won Hong Ju-Hyung Moon Sung-Soo Ahn Eui-Hyun Kim Seung-Koo Lee Eun-Jig Lee Yae-Won Park Cheol-Ryong Ku Efficacy and Cerebrospinal Fluid Rhinorrhea after Cabergoline Treatment in Patients with Bioactive Macroprolactinoma
description	Predicting dopamine agonist resistance in patients with macroprolactinoma is essential for clinicians to prevent treatment failure and subsequent complications such as medication-induced cerebrospinal fluid (CSF) rhinorrhea. We evaluated the features of patients with cabergoline resistance and CSF rhinorrhea in patients with prolactinomas with prolactin levels ≥1000 ng/mL. A total of 140 patients who were newly diagnosed with prolactinoma secreting only prolactin ≥1000 ng/mL and treated with cabergoline for the first time were included in this study. Based on the hormonal and radiologic response of the prolactinoma, the patients were divided into responders and non-responders. Non-responders (36/140, 25.8%) included a higher number of patients receiving hormone replacement than responders (responders, <i>n</i> (%) = 12(11.5) vs. non-responders = 13(36.1), <i>p</i> = 0.001). In propensity score matching analysis, patients who developed CSF rhinorrhea presented more frequent hormone deficiency than responders regardless of initial cabergoline dose. Hormone deficiency was associated with a greater odds ratio for the risk of non-responders (adjusted odds ratio = 5.13, 95% CI 1.96–13.46, <i>p</i> = 0.001). Cabergoline was effective in bioactive macroprolactinoma. Furthermore, initial cabergoline dose was not significantly associated with long-term responsiveness and development of CSF rhinorrhea but the hypopituitarism was independently associated with an increased risk of cabergoline resistance and CSF rhinorrhea.
format	article
author	Hae-Kyung Kim Jae-Won Hong Ju-Hyung Moon Sung-Soo Ahn Eui-Hyun Kim Seung-Koo Lee Eun-Jig Lee Yae-Won Park Cheol-Ryong Ku
author_facet	Hae-Kyung Kim Jae-Won Hong Ju-Hyung Moon Sung-Soo Ahn Eui-Hyun Kim Seung-Koo Lee Eun-Jig Lee Yae-Won Park Cheol-Ryong Ku
author_sort	Hae-Kyung Kim
title	Efficacy and Cerebrospinal Fluid Rhinorrhea after Cabergoline Treatment in Patients with Bioactive Macroprolactinoma
title_short	Efficacy and Cerebrospinal Fluid Rhinorrhea after Cabergoline Treatment in Patients with Bioactive Macroprolactinoma
title_full	Efficacy and Cerebrospinal Fluid Rhinorrhea after Cabergoline Treatment in Patients with Bioactive Macroprolactinoma
title_fullStr	Efficacy and Cerebrospinal Fluid Rhinorrhea after Cabergoline Treatment in Patients with Bioactive Macroprolactinoma
title_full_unstemmed	Efficacy and Cerebrospinal Fluid Rhinorrhea after Cabergoline Treatment in Patients with Bioactive Macroprolactinoma
title_sort	efficacy and cerebrospinal fluid rhinorrhea after cabergoline treatment in patients with bioactive macroprolactinoma
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/e9510b45db974f3390a6d6e6d2b51516
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Efficacy and Cerebrospinal Fluid Rhinorrhea after Cabergoline Treatment in Patients with Bioactive Macroprolactinoma

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