Vnitr Lek 2022, 68(7):E17-E22 | DOI: 10.36290/vnl.2022.101

Pegvisomant in the treatment of acromegaly

Ivana Ságová1, 2, Marián Mokáň2, Juraj Payer3, Peter Vaňuga1
1 Endokrinologické oddelenie, Národný endokrinologický a diabetologický ústav Ľubochňa
2 1. interná klinika UN a JLFUK Martin
3 V. interná klinika LFUK a UN Bratislava

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: acromegaly, insulin‑like growth factor 1, pegvisomant, growth hormone.

Accepted: October 26, 2022; Published: October 31, 2022  Show citation

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Ságová I, Mokáň M, Payer J, Vaňuga P. Pegvisomant in the treatment of acromegaly. Vnitr Lek. 2022;68(7):E17-22. doi: 10.36290/vnl.2022.101.
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