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Santharam, Sandhya, Fountas, Athanasios, Tampourlou, Metaxia, Arlt, Wiebke, Ayuk, John, Gittoes, Neil, Toogood, Andrew and Karavitaki, Niki (2018) Impact of menopause on outcomes in prolactinomas after dopamine agonist treatment withdrawal. Clinical endocrinology, 89 (3). pp. 346-353. ISSN 1365-2265. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Full text not available from this repository.Abstract
OBJECTIVE
Discontinuation of dopamine agonist (DA) treatment in women with prolactinoma after menopause is a potential approach; studies systematically assessing long-term outcomes are lacking. Our aim was to investigate the natural history of prolactinoma in this group.
DESIGN/PATIENTS
Retrospective cohort study of women with prolactinoma diagnosed before menopause and who after menopause were not on DA.
RESULTS
Thirty women were included. Twenty-eight received DA (median duration 18 years, median age at DA withdrawal 52 years). At last assessment (median follow-up 3 years) and compared with values 6-12 months after stopping DA, Prolactin (PRL) increased in 15%, decreased but not normalized in 33% and was normal in 52%; PRL levels or visible adenoma on imaging before DA withdrawal, treatment duration and presence of macro-/microadenoma at diagnosis were not predictors of normoprolactinaemia at last review, whereas PRL values 6-12 months after stopping DA were. Adenoma regrowth was detected in 2/27 patients (7%), who showed gradual increase in PRL. Comparison with 28 women who had DA withdrawal before their menopause revealed lower risk of hyperprolactinaemia recurrence in the postmenopausal group (HR:0.316, 95% CI: 0.101-0.985, P < .05). Two women with microprolactinoma diagnosed in perimenopausal period had not been offered DA; PRL decreased (but not normalized) during observation of 1 and 8 years.
CONCLUSIONS
Prolactin normalized over time in nearly half of the women and serum PRL 6-12 months after DA withdrawal is useful predictor. Nonetheless, 7% of the patients demonstrated adenoma regrowth which, given the life expectancy postmenopause, necessitate regular monitoring of the cases with persistent hyperprolactinaemia.
| Item Type: | Article |
|---|---|
| Additional Information: | This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs |
| Subjects: | WK Endocrine system. Endocrinology WP Gynaecology. Women’s health |
| Divisions: | Ambulatory Care |
| Related URLs: | |
| Depositing User: | Jennifer Manders |
| Date Deposited: | 26 Nov 2019 12:53 |
| Last Modified: | 26 Nov 2019 12:53 |
| URI: | http://www.repository.uhblibrary.co.uk/id/eprint/2620 |
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