New medical approaches in pituitary adenomas

Annamaria Colao, Antonella Di Sarno, Paolo Marzullo, Carolina Di Somma, Gaetana Cerbone, Maria Luisa Landi, Antongiulio Faggiano, Bartolomeo Merola, Gaetano Lombardi

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Recently, the medical approach to patients with secreting and clinically non-functioning pituitary adenomas has received great impulse thanks to the availability of new, selective and long-lasting compounds with dopaminergic activity, such as cabergoline, and of somatostatin analogues provided in slow-release formulations, such as lanreotide and octreotide long acting release (LAR). In particular, the use of cabergoline has induced control of hyperprolactinaemia and tumour shrinkage in the great majority of patients with micro- and macroprolactinomas. Cabergoline treatment restores fertility both in women and men, and partially improves osteoporosis, one of the major complications of hyperprolactinaemia. In acromegaly, disease control (growth hormone [GH] <2.5-1.0 μg/l as a fasting or glucose-suppressed value, respectively, together with age-normalised insulin-like growth factor [IGF]- I) is achievable in more than half of patients receiving treatment with lanreotide or octreotide-LAR. Improvement in cardiomyopathy, sleep apnoea and arthropathy has been reported during GH/IGF-I suppression after pharmacotherapy. A synthetic GH analogue, B2036-PEG, that antagonises endogenous GH binding to its receptor-binding sites and a GH-releasing hormone antagonist that blocks the effect of this releasing factor on the hypothalamus and pituitary are presently under investigation in acromegaly. Preliminary studies have clearly demonstrated the effectiveness of the GH receptor antagonist in suppressing IGF-I levels in acromegalic patients previously unresponsive to somatostatin analogues. Beneficial effects of subcutaneous octreotide and lanreotide have also been reported in adenomas secreting thyroid-stimulating hormone, while the results of treatment with dopamine agonists or somatostatin analogues remain disappointing in patients with clinically non-functioning adenomas. In these patients the possibility of visualising in vivo the expression of D2 receptors using specific radiotracers such as 123I-methoxybenzamide has allowed selection of patients likely to respond to cabergoline. Scant effects of pharmacotherapy have also been reported in patients with adenomas secreting adrenocorticotropic hormone. However, some preliminary data suggest a potential use of cabergoline in combination with ketoconazole, or alone, in selected cases of Cushing's disease or Nelson's syndrome. Copyright (C) 2000 S. Karger AG, Basel.

Original languageEnglish
Pages (from-to)76-87
Number of pages12
JournalHormone Research
Volume53
Issue numberSUPPL. 3
Publication statusPublished - 2000

Fingerprint

Pituitary Neoplasms
Growth Hormone
Octreotide
Somatostatin
Insulin-Like Growth Factor I
Adenoma
Hormone Antagonists
Prolactinoma
Hyperprolactinemia
Acromegaly
Nelson Syndrome
Somatotropin Receptors
Drug Therapy
Pituitary ACTH Hypersecretion
Growth Hormone-Releasing Hormone
Ketoconazole
Cushing Syndrome
Joint Diseases
Dopamine Agonists
Sleep Apnea Syndromes

Keywords

  • Acromegaly
  • Adrenocorticotropic hormone
  • Clinically non-functioning adenomas
  • Cushing's disease
  • Growth hormone
  • Prolactin
  • Prolactinomas

ASJC Scopus subject areas

  • Endocrinology

Cite this

Colao, A., Di Sarno, A., Marzullo, P., Di Somma, C., Cerbone, G., Landi, M. L., ... Lombardi, G. (2000). New medical approaches in pituitary adenomas. Hormone Research, 53(SUPPL. 3), 76-87.

New medical approaches in pituitary adenomas. / Colao, Annamaria; Di Sarno, Antonella; Marzullo, Paolo; Di Somma, Carolina; Cerbone, Gaetana; Landi, Maria Luisa; Faggiano, Antongiulio; Merola, Bartolomeo; Lombardi, Gaetano.

In: Hormone Research, Vol. 53, No. SUPPL. 3, 2000, p. 76-87.

Research output: Contribution to journalArticle

Colao, A, Di Sarno, A, Marzullo, P, Di Somma, C, Cerbone, G, Landi, ML, Faggiano, A, Merola, B & Lombardi, G 2000, 'New medical approaches in pituitary adenomas', Hormone Research, vol. 53, no. SUPPL. 3, pp. 76-87.
Colao A, Di Sarno A, Marzullo P, Di Somma C, Cerbone G, Landi ML et al. New medical approaches in pituitary adenomas. Hormone Research. 2000;53(SUPPL. 3):76-87.
Colao, Annamaria ; Di Sarno, Antonella ; Marzullo, Paolo ; Di Somma, Carolina ; Cerbone, Gaetana ; Landi, Maria Luisa ; Faggiano, Antongiulio ; Merola, Bartolomeo ; Lombardi, Gaetano. / New medical approaches in pituitary adenomas. In: Hormone Research. 2000 ; Vol. 53, No. SUPPL. 3. pp. 76-87.
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