THE EFFECT OF RALOXIFENE ON SERUM PROLACTIN LEVEL IN PATIENTS WITH PROLACTINOMA
THE EFFECT OF RALOXIFENE ON SERUM PROLACTIN LEVEL IN PATIENTS WITH PROLACTINOMA
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DOI：
10.4158/ep-2018-0321
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发表时间：
2019-07-01
影响因子：
4.2
通讯作者：
Dobri, Georgian
中科院分区：
文献类型：
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作者：
Choudhary, Chitra;Hamrahian, Amir H.;Dobri, Georgian
目的：评价雷洛昔芬在多巴胺激动剂（DA）治疗的基础上对催乳素（PRL）水平的影响。方法：我们对14例连续6个月服用稳定剂量DA的催乳素瘤患者进行回顾性图表回顾，这些患者每天服用雷洛昔芬60mg，因为尽管服用相当大剂量的DA， PRL仍不能正常。患者被告知，雷洛昔芬未被美国食品和药物管理局批准用于催乳素瘤的治疗。在雷洛昔芬开始使用后1至6个月和停药后1至3个月测量PRL水平。14例患者中有8例在治疗2（1 ~ 6）个月后停止使用雷洛昔芬，因为感觉PRL水平的绝对变化很小。结果：中位年龄和男女性别比分别为50岁（18 ~ 63岁）和68岁。卡麦角林的基线DA剂量为3mg /周（0.5 - 7mg /周），溴隐亭为15mg /天。10例患者在接受雷洛昔芬治疗1 - 6个月后，PRL的绝对值和百分比分别较基线下降8.3 ng/mL （1.5 - 54.2 ng/mL）和25.9%（8 - 55%）。在PRI下降的10例患者中，第2级（20%）实现了PRL正常化。2例患者PRL水平无变化，2例患者PRL水平分别升高22.8 ng/mL和8.8 ng/mL（47%和23.6%）。结论：雷洛昔芬与10/14例（71%）接受稳定剂量DA治疗的泌乳素瘤患者PRL水平下降25.9%（8 ~ 55%）相关，其中2例（14%）达到正常泌乳素血症。
Objective: To evaluate the effect of raloxifene on prolactin (PRL) levels in addition to dopamine agonist (DA) therapy in patients with prolactinoma.Methods: We conducted a retrospective chart review of 14 patients with prolactinoma on stable dose of DA for 6 months who received raloxifene 60 mg daily, as PRL could not be normalized despite being on fairly high doses of DA. Patients were informed that raloxifene is not approved by the Food and Drug Administration for prolactinoma treatment. PRL level was measured at 1 to 6 months after starting raloxifene and at 1 to 3 months following its discontinuation. Raloxifene was stopped in 8 out of 14 patients after 2 (1 to 6) months of treatment as the absolute change in PRL level was felt to be small.Results: The median age and female/male sex ratios were 50 years (range 18 to 63 years), 68 respectively. The baseline DA dose was 3 mg/week (0.5 to 7 mg/week) for cabergoline and 15 mg/day for bromocriptine. Ten patients had an absolute and percentage decrease in PRL of 8.3 ng/ mL (1.5 to 54.2 ng/mL) and 25.9% (8 to 55%) from base- line, respectively, after 1 to 6 months on raloxifene treatment. Among 10 patients with a decrease in PRI., level, 2 (20%) achieved PRL normalization. Two patients had no change in PRL and two patients had an increase in PRL level by 22.8 ng/mL and 8.8 ng/mL (47% and 23.6%), respectively.Conclusion: Raloxifene was associated with a 25.9% (8 to 55%) decrease in PRL level in 10/14 (71%) patients with prolactinoma who were on stable doses of DA including 2 patients (14%) who achieved normoprolactinemia.