Description
Dopamine agonist therapy is the treatment of choice for prolactinomas. There is however no consensus on either, how long to continue this treatment, or under which circumstances it should be withdrawn. This article reviews the rationale for attempting to stop treatment and the evidence to support this.
Available studies show highly variable remission rates of 6.6 – 67% on stopping dopamine agonist therapy. These findings must be tempered by the fact that duration of followup is limited while the progression of prolactinomas is usually very slow.
A better response to treatment in terms of tumour resolution and lower nadir prolactin levels appears to predict remission. Smaller original tumours, younger patient age and relatively short duration of treatment may also be predictive factors.
