LONG-TERM TREATMENT OF ACROMEGALIC PATIENTS WITH REPEATABLE PARENTERAL DEPOT-BROMOCRIPTINE

We studied the efficacy and tolerability of a repeatable long-acting p arenteral depot-bromocriptine preparation (Parlodel LAR) in 14 acromeg alic patients, 10 of whom had received oral bromocriptine therapy prev iously, 2 of them showing intolerance to oral bromocriptine. Patients received i.m. injections of 50-100 mg depot-bromocriptine at 4-week in tervals for 3-24 months (median 6). Growth hormone profiles were asses sed by four daily samples at 4-week intervals. Main daily growth hormo ne levels decreased from 52.1 +/- 12.3 mug/l (mean +/- SEM) to 19.4 +/ - 4.7 mug/l on the day of injection. In 6 patients, growth hormone val ues were lowered by more than 50%, whereas IGF-I levels decreased only slightly and growth hormone values during the oral glucose tolerance test remained non-suppressible. Tumour sizes were not affected. Two wo men became pregnant and were delivered of healthy babies. Side-effects typical of bromocriptine occurred frequently on the days of injection and diminished in most patients after 2 months of therapy despite inc reasing dosage. Compared with previous oral bromocriptine therapy, 9 o f 10 patients preferred the depot preparation, whereas the reduction o f growth hormone levels was similar during both treatments. In conclus ion, depot-bromocriptine should be considered for acromegalic patients intolerant to oral bromocriptine.