The Effect of Raloxifene on Serum Prolactin Level in Patients with Prolactinoma |
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| Institution: | 1. From Department of Endocrinology, Diabetes and Metabolism, Bayhealth, Dover, Delaware;2. Department of Endocrinology, Diabetes and Metabolism, Johns Hopkins University, Baltimore, Maryland;3. Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio;4. Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio;5. Department of Endocrinology, Diabetes and Metabolism, Cleveland Clinic, Cleveland, Ohio;6. Department of Neuro-Endocrinology in Clinical Neurological Surgery, Weill Cornell Medicine, New York, New York.;3. Department of Obstetrics and Gynecology, University of Miami, 1611 NW 12th Ave, Miami, FL 33136, USA;4. Endocrinology and Reproduction Research Branch, Section on Hormonal Regulation, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA;1. From the Department of Nuclear Medicine, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China.;2. Department of Gastrointestinal Medicine, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China.;3. Department of Endocrinology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China. |
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| Abstract: | 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), 6/8 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 baseline, respectively, after 1 to 6 months on raloxifene treatment. Among 10 patients with a decrease in PRL 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.Abbreviations: CV = coefficient of variation; DA = dopamine agonist; FSH = follicule-stimulating hormone; LH = luteinizing hormone; PRL = prolactin; PTTG = pituitary tumor transforming gene |
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