Since the initial observation of a GH-lowering effect of l-dopa in acromegalic patients (1, 2), dopamine agonist drugs have been widely employed as therapeutic agents in the treatment of acromegaly. However, cross-sectional analysis of 514 patients treated with bromocriptine (7.5–20 mg daily, with multiple administration) revealed rather disappointing results (3). Long-term treatment with bromocriptine seldom produced significant shrinkage of GH-secreting pituitary adenomas (4) and in fact lowered plasma GH levels to below 5 μg/l in only 21% of cases. If stricter criteria of normality were adopted, to include the achievement of a normal basal level of IGF-I, the efficacy of bromocriptine treatment of acromegalic patients was reduced to about 8%. In addition, the development of a long-acting somatostatin analogue, octreotide, has been a major advance in the medical treatment of acromegaly, and this has diminished the interest in dopamine agonist drugs.
In the present issue of European Journal of Endocrinology