Combined use of a somatostatin analog and a dopamine agonist for treatment of CD has been proposed on the basis of similar studies suggesting additive effects on growth hormone secretion from somatotroph adenomas [60]. In a study of 17 patients with CD, pasireotide monotherapy (100–250 mcg three times a day) normalized UFC levels in 5 patients, and addition of cabergoline (0.5–1.5 mg every other day) normalized UFC levels in 4 more patients. Among the remaining 8 patients, subsequent addition of ketoconazole (200 mg three times a day) normalized UFC levels in 6, leaving only 2 patients who still had elevated UFC levels. Thus, sequential therapy using these three agents shows promise but requires further studies of both efficacy and safety [61].