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Pegvisomant and current approaches to the medical treatment of acromegaly (literature review and case report)

https://doi.org/10.14341/omet12207

Abstract

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.

About the Authors

Larisa K. Dzeranova
Endocrinology Research Centre
Russian Federation

ScD



Alexandra A. Povaliaeva
Endocrinology Research Centre
Russian Federation

M.D.



Anastasia A. Romanova
Endocrinology Research Centre
Russian Federation

M.D.



Elena G. Przhiyalkovskaya
Endocrinology Research Centre
Russian Federation

PhD



Ekaterina A. Pigarova
Endocrinology Research Centre
Russian Federation

MD, PhD



Natalia S. Fedorova
Endocrinology Research Centre
Russian Federation

MD, PhD



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Supplementary files

1. Picture 1
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Type Исследовательские инструменты
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2. Fig. 1. Effects of somatostatin and pegvisomant analogues in patients with acromegaly (adapted from [24])
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Type Other
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3. Fig. 1. Effects of somatostatin and pegvisomant analogues in patients with acromegaly (adapted from [24])
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Type Other
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Review

For citations:


Dzeranova L.K., Povaliaeva A.A., Romanova A.A., Przhiyalkovskaya E.G., Pigarova E.A., Fedorova N.S. Pegvisomant and current approaches to the medical treatment of acromegaly (literature review and case report). Obesity and metabolism. 2019;16(4):73-79. (In Russ.) https://doi.org/10.14341/omet12207

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ISSN 2306-5524 (Online)