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Colao, A. et al.

Colao, Pivonello, Cappabianca, Auriemma, De Martino, Ciccarelli, de Divitiis, Lombardi,

The use of a GH receptor antagonist in patients with acromegaly resistant to somatostatin analogs.

Pegvisomant, a GH receptor antagonist, is a new pharmaceutical approach to acromegaly. It enables IGF-I levels to return in the age- and sex-reference range in approximately 90% of patients. This new approach is particularly beneficial in those patients who do not experience control of hormone hypersecretion after surgery and/or medical treatment with somatostatin analogs. In our preliminary experience, out of 16 patients unsuccessfully operated on by transsphenoidal surgery and resistant to 40-mg octreotide-LAR or 120-mg lanreotide for at least 6 months, 13 normalized their IGF-I levels within 6 months from treatment beginning. Normalization of IGF-I levels was accompanied by a significant decrease of ring size. We did not observe any increase of tumor remnant in this short period of treatment. In two cases we observed a significant increase of liver transaminases levels. In conclusion, more than 80% of patients with acromegaly unsuccessfully treated by surgery or currently available somatostatin analogs can achieve normal IGF-I levels after short-term treatment with pegvisomant.[1]

References

The use of a GH receptor antagonist in patients with acromegaly resistant to somatostatin analogs. Colao, A., Pivonello, R., Cappabianca, P., Auriemma, R.S., De Martino, M.C., Ciccarelli, A., de Divitiis, E., Lombardi, G. J. Endocrinol. Invest. (2003) [Pubmed]

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