Cushing’s Disease: Sustained remission in five cases induced by medical therapy with the dopamine agonist cabergoline

We report five cases of cushing’s disease where the patients were given a therapeutic trial of cabergoline. morning serum cortisol, adrenocorticotrophic hormone (acth), and sleeping cortisol concentrations were significantly raised. magnetic resonance imaging (mri) scans revealed pituitary microadenomas in 3 patients but were normal in the others. ectopic acth production was excluded in the 2 patients with normal mri scans. all were given a therapeutic trial of cabergoline (1 mg daily). four patients responded with a prompt fall in serum cortisol levels and had a sustained clinical and biochemical remission for 378, 44, 28 and 14 days, respectively. one patient failed to respond. in conclusion, we suggest that all patients with cushing’s disease should undergo a therapeutic trial of cabergoline. responders can then be prepared for surgery or, if needed, treated medically in the long term