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Lipodystrophy in patients with acromegaly receiving pegvisomant
Vivien S Bonert1, Laurence Kennedy, Stephan Petersenn
1Department of Medicine, Cedars-Sinai Medical Center, David Geffen School of Medicine at University of California, Los Angeles, California 90048, USA. Vivian.Bonert@cshs.org
The Journal of Clinical Endocrinology and Metabolism
|July 10, 2008
Summary
Pegvisomant, used for acromegaly, can cause lipohypertrophy at injection sites. Discontinuing the drug led to regression of lipohypertrophy in patients, highlighting the need for injection site monitoring.
Area of Science:
- Endocrinology
- Pharmacology
Background:
- Pegvisomant is a growth hormone (GH) receptor antagonist effective in normalizing serum IGF-I levels in acromegaly patients.
- Commonly reported side effects include headache, injection site reactions, flu-like syndrome, and transient hepatic enzyme elevations.
Observation:
- Seven acromegaly patients developed lipodystrophy (abnormal fat tissue) at pegvisomant injection sites.
- Affected sites included the abdomen, thigh, buttock, and upper arm.
Findings:
- Four patients discontinued pegvisomant due to lipohypertrophy, with subsequent regression of the condition.
- Two patients experienced recurrence of lipohypertrophy upon rechallenge with pegvisomant.
Implications:
- Frequent examination of injection sites for lipohypertrophy is crucial for patients on pegvisomant therapy.
- The development of lipohypertrophy may necessitate treatment discontinuation or careful site rotation.
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