BROMOCRIPTINE THERAPY IN ACROMEGALY: EFFECTS ON PLASMA GH LEVELS, SOMATOMEDIN‐C LEVELS AND CLINICAL ACTIVITY

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Abstract
SUMMARY: Thirty‐one patients with active acromegaly were treated with 10–20 mg bromocriptine daily for a period of 6–9 months. The clinical response was evaluated both by a subjective ‘score of symptoms’, and by a combined subjective and objective ‘clinical and metabolic improvement score’(c‐m score). The biochemical response was evaluated both by measurement of the mean of four plasma growth hormone (GH) determinations during the day and by measurement of plasma somatomedin‐C (Sm‐C) concentration. The clinical response as assessed by both methods showed a better correlation with changes in plasma GH levels (respectively r= 0·33; r= 0·50) than with changes in Sm‐C levels (r= 0·20; r= 0·36). The study confirms that in some patients clinical improvement is not accompanied by a decrease of plasma GH concentration. However, it is not possible to identify a subgroup of patients who showed clinical improvement with a decrease of Sm‐C levels, but whose plasma GH levels remained constant. It is concluded that measurement of plasma GH levels still appears to be the most useful biochemical assessment of disease activity in bromocriptine‐treated acromegaly.