Study of Clinical Profile and Early Response to Dopamine Agonist Therapy in Patients of Hyperprolactinemia: Experience at a Tertiary Care Centre of Nepal.

Introduction: Pathological hyperprolactinemia is medically treatable condition with dopamine agonist therapy. This research was aimed to study clinical profiles of patients of hyperprolactinemia started on cabergoline and assess clinical, biochemical, and radiological response to treatment at the end of 6 months. Methods: This was prospective observational study conducted over 1 year duration. All patients of pathological hyperprolactinemia who were started on cabergoline were included in this study. Cabergoline was started at 0.5 mg/week for idiopathic hyperprolactinemia and pituitary microadenomas, and 1 mg/week for macroadenomas. Clinical and biochemical responses in the form of resolution of clinical symptoms and reduction of prolactin levels were assessed at regular intervals till 6 months. With respect to tumoural hyperprolactinemia, repeat imaging was done after 6 months to assess for a tumour volume reduction of ≥50% from baseline. Results: Out of 33 patients, 42.42% had pituitary microadenomas, 33.34% had macroadenomas, and 24.24% had idiopathic hyperprolactinemia. At presentation, the median prolactin levels were higher for pituitary macroadenomas (202 ng/ml) as compared to microadenomas (80.7 ng/ml) and idiopathic hyperprolactinemia (75.7 ng/ml) ( Conclusion: Cabergoline was highly efficacious for treatment of both tumoural and non-tumoural hyperprolactinemia with significant early clinical, biochemical, and radiological response to treatment.