ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet12207ometendo-12207Research ArticleСлучай из практикиCase ReportПэгвисомант и современные подходы к медикаментозному лечению акромегалии (обзор литературы и описание клинического случая)Pegvisomant and current approaches to the medical treatment of acromegaly (literature review and case report)https://orcid.org/0000-0002-0327-4619ДзерановаЛариса КонстантиновнаDzeranovaLarisa K.

эндокринолог, д.м.н., ученый секретарь, ведущий научный сотрудник отделения нейроэндокринологии и остеопатий

ScD

dzeranovalk@yandex.ruhttps://orcid.org/0000-0002-7634-5457ПоваляеваАлександра АлександровнаPovaliaevaAlexandra A.

эндокринолог, ассистент методического аккредитационно-симуляционного центра

M.D.

a.petrushkina@yandex.ruhttps://orcid.org/0000-0001-7112-5896РомановаАнастасия АлександровнаRomanovaAnastasia A.

эндокринолог

M.D.

svetasvetikova1535@gmail.comhttps://orcid.org/0000-0001-9119-2447ПржиялковскаяЕлена ГеоргиевнаPrzhiyalkovskayaElena G.

к.м.н.

PhD

przhiyalkovskaya.elena@gmail.comhttps://orcid.org/0000-0001-6539-466XПигароваЕкатерина АлександровнаPigarovaEkaterina A.

к.м.н.

MD, PhD

kpigarova@gmail.comhttps://orcid.org/0000-0002-9816-5043ФедороваНаталья СергеевнаFedorovaNatalia S.

к.м.н.

MD, PhD

fedorova.n.s.12@gmail.comФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава РоссииРоссияEndocrinology Research CentreRussian Federation2019251220191647379Copyright © Дзеранова Л.К., Поваляева А.А., Романова А.А., Пржиялковская Е.Г., Пигарова Е.А., Федорова Н.С., 20192019Дзеранова Л.К., Поваляева А.А., Романова А.А., Пржиялковская Е.Г., Пигарова Е.А., Федорова Н.С.Dzeranova L.K., Povaliaeva A.A., Romanova A.A., Przhiyalkovskaya E.G., Pigarova E.A., Fedorova N.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/12207

В данном обзоре приводятся основные результаты клинических исследований и описанный в литературе опыт применения пэгвисоманта – первого препарата из класса антагонистов рецептора соматотропного гормона. Подробно обсуждаются механизм действия препарата, его эффективность в отношении контроля заболевания и влияние на осложнения, информация о нежелательных явлениях, а также приводятся краткие сведения об опыте применения во время беременности. В завершение приводится клиническое наблюдение успешного применения пэгвисоманта при резистентной к стандартному лечению акромегалии. Обсуждение имеющихся литературных данных, результатов клинических исследований и опыта применения в практике позволяет сделать вывод о том, что данный препарат высокоэффективен с точки зрения достижения биохимической ремиссии акромегалии, а также обладает рядом дополнительных ценных свойств: способен улучшать показатели углеводного обмена, повышает качество жизни пациентов и имеет минимальное количество нежелательных явлений. В настоящее время пэгвисомант зарегистрирован в РФ только для использования в монотерапии; возможность назначения препарата в комбинированной терапии с аналогами соматостатина позволит, кроме того, надежно контролировать рост аденомы гипофиза и существенно снизить затраты на лечение за счет уменьшения дозы пэгвисоманта. Указанные особенности препарата делают его весьма актуальным при обсуждении вопросов, связанных с медикаментозной терапией акромегалии, и предполагают хорошую перспективу для использования в клинической практике.

This review provides the main results of clinical trials and the literature on the experience of using pegvisomant, the first drug from the class of growth hormone receptor antagonists. The mechanism of action of the drug, its effectiveness with respect to disease control and its effect on complications, information on adverse events, and brief information on the experience of use during pregnancy are discussed in detail. In conclusion, a clinical observation of successful use of pegvisomant in resistant to standart treatment acromegaly is given. A discussion of the available literature data, the results of clinical studies and practical experience allows us to conclude that the drug is highly effective in terms of achieving biochemical remission of acromegaly, and also has a number of additional valuable properties: it is capable of improvement of patients’ glucose metabolism and quality of life and has a minimal amount of adverse events. Pegvisomant is currently registered in the Russian Federation only for use in monotherapy; the possibility of combination therapy with somatostatin analogues will additionally allow to reliably control the growth of the pituitary adenoma and significantly cut treatment costs by reducing the dose of pegvisomant. These features of the drug make it very relevant when discussing issues related to drug therapy of acromegaly, and suggest a good prospect for use in clinical practice.

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The authors declare that there are no conflicts of interest present.