Pegvisomant in the treatment of acromegaly
Authors:
Ivana Ságová 1,2; Marián Mokáň 2; Juraj Payer 3; Peter Vaňuga 1
Authors‘ workplace:
Endokrinologické oddelenie, Národný endokrinologický a diabetologický ústav Ľubochňa
1; 1. interná klinika UN a JLFUK Martin
2; V. interná klinika LFUK a UN Bratislava
3
Published in:
Vnitř Lék 2022; 68(E-7): 17-22
Category:
Review Articles
doi:
https://doi.org/10.36290/vnl.2022.101
Overview
Despite improvements in surgical techniques, current radiotherapy options and development of long-acting somatostatin analogues, biochemical control of acromegaly is not achieved in some patients. The failure to achieve optimal serum growth hormone (RH) and insulin-like growth factor-1 (IGF-1) levels means increased morbidity and mortality of acromegaly patients. The RH receptor antagonist pegvisomant (PEG) is a genetically engineered RH analog that prevents of RH receptor dimerization, i.e. a process that is crucial for the action of RH at the cellular level. The effect of the treatment is suppression of IGF-1 production. In pilot studies, normalization of IGF-1 levels was achieved in up to 90 % of patients receiving PEG. However, PEG efficacy in clinical settings is slightly lower (65 to 97 %) than reported in the key studies. A rare side effect of treatment is elevations of liver transaminases. In addition, pituitary tumor growth progression has been reported in several cases. In this review article, we present long-term data on pegvisomant treatment and discuss its associated risks and benefits.
Keywords:
Growth hormone – acromegaly – insulin‑like growth factor 1 – pegvisomant
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