Recovery from hypogonadism in men with prolactinoma treated with dopamine agonists
Authors' conclusion
Testosterone levels recover in a small majority of men with prolactinoma mostly during the first year of DA treatment. However, testosterone replacement could be considered earlier in patients with large and compressive tumors, and in whom testosterone remains below 7.4 nmol/l after 6 months of DA treatment.
Study context
- Population
- Men with prolactinoma treated with dopamine agonists (DA) (77/97 macroprolactinomas); excluded primary hypogonadism, surgery <12 months after DA initiation, tumors <5 mm or prolactin <45 µg/l at diagnosis
- Participants
- 97 men
- Exposure
- NT vs LT
- NTn = 12
- LTn = 85
- Outcome
- Extent, timeline and predictive factors of gonadotropic axis recovery
Main finding
As reported in the abstract
Recovery from hypogonadism at 6 months
43%
Recovery from hypogonadism at 12 months
50%
Recovery from hypogonadism at 24 months
54%
Recovery at 6, 12 and 24 months if prolactin was normal
61%, 69 and 69%
Observational data: associations, not effects.
Further findings
Testosterone in NT · diagnosis to 6 months
- Mean testosterone rose from 13.5 nmol/l to 17.1nmol/l at 6 months (n = 11; p < 0.05), then stable at 12 months (n = 8)
Testosterone in LT · diagnosis to 12 months
- Mean testosterone rose from 5.2 nmol/l to 9.6 nmol/l at 6 months (n = 66; p < 0.001) and to 13.1nmol/l at 12 months (n = 40; p < 0.001), then stable
Predictors of persistent hypogonadism at 12 months
- Most significant independent predictor: testosterone <7.4 nmol/l at 6 months, sensitivity
- 91%
- Testosterone <7.4 nmol/l at 6 months, specificity
- 94%
- Independent baseline factors: visual field deficit and lower testosterone levels
Original publication
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