Retrospective comparison of cabergoline and bromocriptine effects in hyperprolactinemia: a single center experience

Introduction Patients with hyperprolactinemia who require medical therapy are typically treated with dopamine agonists (DAs). In most cases, DAs normalize prolactin levels, control symptoms, and substantially decrease tumor size. Here, we aimed to compare the efficacy of cabergoline (CAB) and bromocriptine (BRC) in patients with hyperprolactinemia at a single center. Methods Retrospective analysis of the clinical records of 498 patients with hyperprolactinemia [mean age 33.3 +/- 10.8 years (range 16-66), 450 women, and 48 men] who had received either CAB (n = 450) or BRC (n = 48) was performed. Results The mean age, gender distribution, and treatment duration were similar between the CAB and BRC groups (33.2 +/- 11 vs. 34.1 +/- 9.6 years, male/female 44/406 vs. 4/44, 18.7 +/- 12.1 vs. 17.8 +/- 6.0 months, respectively; p > 0.05 for all). Mean dosage was 1.5 +/- 1.6 mg/week for CAB and 3.8 +/- 2.7 mg/day for BRC. Baseline prolactin levels, frequency of galactorrhea, amenorrhea, oligomenorrhea, erectile dysfunction, infertility, and visual impairment were similar between the two groups, whereas the baseline tumor volume was higher in the CAB group. The prolactin normalization rate (87.4 vs. 41.4 %, p = 0.029) and tumor volume shrinkage (79.8 +/- 39.1 vs. 54.1 +/- 55.3 %, p = 0.015) were significantly higher in the CAB-treated patients than in the BRC-treated patients, while the tumor cure rates were similar. Symptom relief was higher in the CAB group than in the BRC group. More side effects were recorded in patients who took BRC (29.1 vs. 5.3 %, p < 0.001). Conclusion Our data revealed that CAB was more effective than BRC in controlling symptoms associated with hormone excess, normalizing serum prolactin levels, and shrinking prolactinomas.