Pegvisomant: Clinical use in patients with acromegaly
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GH antagonist

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Román-González, A., Padilla-Zambrano, H., Builes-Barrera, C. A., & Tovar, H. (2022). Pegvisomant: Clinical use in patients with acromegaly. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 9(3).


Background: Currently, the management of patients with acromegaly includes surgery, radiation therapy, and drug therapy. Although surgery is the first-line treatment, a large percentage of patients will require additional management with radiotherapy and pharmacotherapy.

Purpose: To review the pharmacology and clinical studies of pegvisomant.

Methodology: Electronic databases such as Medline and PubMed were searched with the term pegvisomant. Clinical studies and relevant data regarding pegvisomant in the management of acromegaly are presented.

Results: Somatostatin analogs are the cornerstone of drug therapy for this entity; however, recent studies have reported low rates of disease control. To achieve better control, Pegvisomant has been introduced. This drug is a growth hormone analog that binds to the receptor but does not induce conformational changes for signal transduction. Therefore, it does not inhibit growth hormone secretion but rather its physiological effects on target tissues. To date, it has shown efficacy in normalizing serum IGF-1 levels both in monotherapy and in combination therapy.

Conclusions: Absence of acromegaly control despite first line treatment should trigger consideration of second line treatment like pegvisomant or pasireotide. Individual characteristics allow the clinician to choose the better option to the patient. Pegvisomant is an effective drug to control this disease.
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