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Pegvisomant in acromegaly: an update.

A Giustina1, G Arnaldi2, F Bogazzi3

  • 1Chair of Endocrinology, Vita-Salute San Raffaele University, Milano, Italy. a.giustina@libero.it.

Journal of Endocrinological Investigation
|February 9, 2017
PubMed
Summary
This summary is machine-generated.

Pegvisomant (PEG) is a powerful treatment for acromegaly, effectively controlling IGF-I levels and improving patient outcomes. Despite its benefits, optimizing PEG

Keywords:
AcromegalyIGF-IMetabolic effectsPegvisomantReviewSRL resistance

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Area of Science:

  • Endocrinology
  • Pharmacology

Background:

  • A previous review of pegvisomant (PEG) in acromegaly treatment was published in 2007.
  • New evidence has since emerged regarding PEG's biochemical and clinical effects, long-term efficacy, and safety.

Purpose of the Study:

  • To review emerging aspects of PEG use in clinical practice.
  • To incorporate the most recent literature on PEG for acromegaly treatment.

Main Methods:

  • Literature review of recent studies on pegvisomant.
  • Analysis of clinical practice, efficacy, safety, and specific patient populations.

Main Results:

  • Pegvisomant remains the most potent tool for controlling IGF-I in acromegaly, improving signs, symptoms, quality of life, and comorbidities.
  • Long-term follow-up data address safety concerns, including tumor (re)growth, and highlight PEG's positive or neutral impact on glucose metabolism.
  • Clinical experience with sleep apnea and pregnancy, and the concept of somatostatin receptor ligand (SRL) resistance have been reviewed to define optimal patient selection for PEG therapy.

Conclusions:

  • Pegvisomant is an effective and safe option for acromegaly patients not adequately controlled by SRL.
  • Optimization of PEG's clinical use is still necessary.