Pegvisomant Treatment in Acromegaly

  title={Pegvisomant Treatment in Acromegaly},
  author={Sebastian Neggers and Ammar Muhammad and Aart J van der Lely},
  pages={59 - 65}
Historically, medical treatment of acromegaly has mainly been used as an adjuvant therapy after surgery. In the last decades, an increased range of medical therapy options has been available. Somatostatin analogues have become the cornerstones of medical treatment in acromegaly and are even seen as a primary treatment in a selected group of acromegaly patients. The most recent medical treatment available for acromegaly patients is pegvisomant, a growth hormone receptor antagonist. To date, it… 

Medical Treatment of Acromegaly with Dopamine Agonists or Somatostatin Analogs

The GH receptor antagonist pegvisomant is helpful in patients who are totally or partially resistant to SAs and can be given in association with both S as and/or DAs.

Pasireotide for the treatment of acromegaly

Pasireotide response biomarkers will allow us to identify good candidates for first-line medical monotherapy with pasireotide and change the treatment of acromegaly towards a more personalized therapeutic decision-making process.

Pegvisomant in acromegaly: an update

PEG increasingly appears to be an effective and safe medical option for many patients not controlled by SRL but its use still needs to be optimized.

New opportunities for secondary drug therapy of acromegaly

Compared to the introduction into clinical practice of various therapeutic agents, which allow, regardless of the activity of the disease, the specificity of the pathomorphological structure of tumor tissue and somatic status, to achieve stable maintenance of biochemical remission, patients have real opportunities for improving the quality and life expectancy.

Treatment Factors That Influence Mortality in Acromegaly

The epidemiological data relating to mortality rates in acromegaly, the relationship between acromEGaly and malignancy, the role of GH and insulin-like growth factor-I in assessing the risk of future mortality, and the impact of radiotherapy and hypopituitarism on mortality are reviewed.

Bone and Joint Disorders in Acromegaly

This overview article summarizes the pathophysiology, diagnosis, clinical picture, disease course and management of skeletal complications of acromegaly, focusing on vertebral fractures and arthropathy.

Quality of Life in Acromegaly

Quality of life (QoL) is impaired in acromegaly, especially in active disease, and QoL is associated with the presence of musculoskeletal pain, headache, having required treatment with radiotherapy, being older, of female gender, with a longer disease duration, coexisting diabetes mellitus, a higher BMI or becoming GH deficient after treatment for acromEGaly.

Novel Techniques in the Surgical Treatment of Acromegaly: Applications and Efficacy

The application of modern technology has only led to a minor improvement of results, but it has widened the spectrum of accessible pathologies and increased the safety of the procedures for the patient.

Switching patients with acromegaly from octreotide to pasireotide improves biochemical control: crossover extension to a randomized, double-blind, Phase III study

Pasireotide LAR is a promising treatment option for patients with acromegaly inadequately controlled with the first-generation somatostatin analogue octreotide LAR, with the exception of the frequency of hyperglycemia-related adverse events.

Efficacy and safety of long-acting pasireotide in Japanese patients with acromegaly or pituitary gigantism: results from a multicenter, open-label, randomized, phase 2 study.

Long-acting pasireotide demonstrated clinically relevant efficacy and was well tolerated in Japanese patients with acromegaly or pituitary gigantism and was maintained up to month 12.



Combination treatment with somatostatin analogues and pegvisomant in acromegaly.

  • S. NeggersA. J. van der Lely
  • Medicine, Biology
    Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society
  • 2011

Long-term effects of pegvisomant in patients with acromegaly

  • I. HodishA. Barkan
  • Biology, Medicine
    Nature Clinical Practice Endocrinology &Metabolism
  • 2008
The long-term data that have been gathered on pegvisomant therapy are presented, the related risks and benefits are discussed, and a potential therapeutic approach is frame.

Medical Treatment of Acromegaly with Dopamine Agonists or Somatostatin Analogs

The GH receptor antagonist pegvisomant is helpful in patients who are totally or partially resistant to SAs and can be given in association with both S as and/or DAs.

Use of Pegvisomant in acromegaly. An Italian Society of Endocrinology guideline

A task force involved endocrinologists recognized experts in the field of acromegaly management and their understanding of the data reported so far worldwide as well as their recommendations for Pegvisomant use in clinical practice are presented here.

Somatostatin analog and pegvisomant combination therapy for acromegaly

Combination treatment with somatostatin analogs and pegvisomant is highly effective at normalizing the level of insulin-like growth factor I in over 90% of patients and might also have a favorable effect on quality of life in those with biochemically controlled acromegaly.

Clinical review: The antitumoral effects of somatostatin analog therapy in acromegaly.

  • J. Bevan
  • Medicine, Biology
    The Journal of clinical endocrinology and metabolism
  • 2005
This review summarizes current knowledge of the effects of somatostatin analogs on tumor size and cellular morphology and examines the available data on predictors of tumor shrinkage.

Treatment of acromegaly with the growth hormone-receptor antagonist pegvisomant.

Treatment of patients who have acromegaly with pegvisomant with a growth hormone-receptor antagonist results in a reduction in serum IGF-I concentrations and in clinical improvement.

Lipodystrophy in patients with acromegaly receiving pegvisomant.

Pegvisomant, a GH receptor antagonist, suppresses serum IGF-I levels into the normal range in more than 95% of patients with acromegaly, and was discontinued due to dissatisfaction with lipohypertrophy by four patients.

The German ACROSTUDY: past and present.

In this presently largest database of acromegalic patients treated with pegvisomant, long-term results are encouraging, and Elevated transaminases usually normalized after discontinuation but in half of the affected patients also despite continuation of treatment without dose alteration.