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CV 205-502: a more effective dopamine agonist in the treatment of acromegaly?

Since the initial observation of a GH-lowering effect of L-dopa in acromegalic patients (1, 2), dopamine agonist drugs have been widely employed as therapeutic agents in the treatment of acromegaly. However, cross-sectional analysis of 514 patients treated with bromocriptine (7.5–20 mg daily, with multiple administration) revealed rather disappointing results (3). Long-term treatment with bromocriptine seldom produced significant shrinkage of GH-secreting pituitary adenomas (4) and in fact lowered plasma GH levels to below 5 µg/l in only 21% of cases. If stricter criteria of normality were adopted, to include the achievement of a normal basal level of IGF-I, the efficacy of bromocriptine treatment of acromegalic patients was reduced to about 8%. In addition, the development of a long-acting somatostatin analogue, octreotide, has been a major advance in the medical treatment of acromegaly, and this has diminished the interest in dopamine agonist drugs.

In the present issue of European Journal of Endocrinology