Abstract
BackgroundProlactinoma is the major cause of hyperprolactinemia, and dopamine agonists (DAs) are generally the first-line treatment for them. Several studies have reviewed the recurrent rate of hyperprolactinemia after DAs withdrawal. However, few of them have concerned the recurrence risk of prolactinoma following the withdrawal of DAs.MethodsThree medical databases, PubMed, EMBASE and Cochrane library, were retrieved up to February, 14, 2021 to identify studies related to recurrence of prolactinoma and withdrawal of DAs. Statistical analyses including meta-analysis, sensitivity analysis, meta-regression, funnel plot and Egger test were performed through software R.ResultsA total of 3225 studies were retrieved from the three data bases, and 13 studies consisted of 616 patients and 19 arms were finally included in this systematic analysis. There was no significant heterogeneity among the included studies, and fixed effect model was thus used. The pooled recurrence proportion of prolactinoma after withdrawal of DA was 2% with a 95% confidence interval (CI) of 1–3%.ConclusionOur study showed a very low recurrent rate of prolactinomas after DAs withdrawal. Much more prospective studies with larger cases and longer follow-up period are encouraged to confirm our finding.Trial registrationRegistration numberCRD42021245888 (PROSPERO).
Highlights
Prolactinoma is the major cause of hyperprolactinemia, and dopamine agonists (DAs) are generally the first-line treatment for them
Prolactinoma is the major cause of hyperprolactinemia, which frequently
DAs are effective in normalizing prolactin levels (68% of patients), reducing tumor size (62% of patients) and relieving infertility (53%) and other symptoms [4]
Summary
Prolactinoma is the major cause of hyperprolactinemia, and dopamine agonists (DAs) are generally the first-line treatment for them. Few of them have concerned the recurrence risk of prolactinoma following the withdrawal of DAs. Pituitary adenomas are one of the most common intracranial tumors, and approximately half of these tumors are hormone-secreting [1]. Prolactinoma is the major cause of hyperprolactinemia, which frequently. Dopamine agonists (DAs), including bromocriptine (BRC) and cabergoline (CAB), are first-line treatments for most of prolactinoma. The recommended duration of DA treatment for prolactinoma is at least two years until normo-prolactinemia and tumor disappearance [4]. The recurrence of hyperprolactinemia after withdrawal of DAs is higher than expected, which is reported as 30–80% [5,6,7,8] according to the type of DAs, treatment
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