Efficacy and cerebrospinal fluid rhinorrhea after cabergoline treatment in patients with bioactive macroprolactinoma

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

Research output: Contribution to journalArticlepeer-review


Predicting dopamine agonist resistance in patients with macroprolactinoma is essential for clinicians to prevent treatment failure and subsequent complications such as medication‐in-duced 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, n (%) = 12(11.5) vs. non‐responders = 13(36.1), p = 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 (ad-justed odds ratio = 5.13, 95% CI 1.96–13.46, p = 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.

Original languageEnglish
Article number5374
Issue number21
Publication statusPublished - 2021 Nov 1

Bibliographical note

Funding Information:
Acknowledgements: This study was supported by the ‘SENTINEL (Severance ENdocri‐ nology daTa scIeNcE pLatform)’ program of the Endocrinology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea (4‐2018‐1215; DUCD000002) in statistical analyses.

Funding Information:
Funding: This study was supported by the “Team Science Award” of Yonsei University College of Medicine (6‐2021‐0009). This study was also supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2020R1I1A1A01071648).

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


Dive into the research topics of 'Efficacy and cerebrospinal fluid rhinorrhea after cabergoline treatment in patients with bioactive macroprolactinoma'. Together they form a unique fingerprint.

Cite this