The need for annual echocardiography to detect cabergoline-associated valvulopathy in patients with prolactinoma: a systematic review and additional clinical data

Based on review (21 studies) and new trial data (n=40) that found only 2 (0.11%) of 1811 patients were confirmed to have cabergoline-associated valvulopathy, researchers challenge the present FDA recommendations to do an annual echo in all patients on treatment for prolactinoma.

The researchers propose that such patients should be screened by a clinical cardiovascular examination and that echocardiogram should be reserved for those patients with an audible murmur, those treated for more than 5 years at a dose of more than 3 mg per week, or those who maintain cabergoline treatment after the age of 50 years.

 

In the UK, patients must undergo a cardiovascular evaluation, including echocardiogram to assess the potential presence of asymptomatic valvular disease before initiating long-term treatment with cabergoline. The next echocardiogram must occur within 3-6 months, and the frequency of monitoring thereafter should be determined by appropriate individual clinical assessment, but must occur at least every 6 to 12 months.