Optimal use of pegvisomant in acromegaly: are we getting there?

Giustina, Andrea

doi:10.1007/s12020-014-0462-0

Cited by 24 publications

(17 citation statements)

References 59 publications

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“…In the study by Parkinson and colleagues, the variables gender, body weight, previous radiotherapy, and baseline GH/IGF-1 influenced the pegvisomant dosage that was needed to normalize IGF-1 levels [21]. In other studies baseline IGF-I, pegvisomant dosage, gender, body weight and a genetic mutation (deletion of 3 exons in the GHR gene (d3GHR) were associated with a better response to pegvisomant or combined therapies including pegvisomant [36][37][38][39].…”

Section: Discussionmentioning

confidence: 98%

Prediction of therapy response in acromegalic patients under pegvisomant therapy within the German ACROSTUDY cohort

Sievers

Baur²,

Schwanke

et al. 2015

Pituitary

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Section: Discussionmentioning

confidence: 98%

Prediction of therapy response in acromegalic patients under pegvisomant therapy within the German ACROSTUDY cohort

Sievers

Baur²,

Schwanke

et al. 2015

Pituitary

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“…Absence of previous irradiation and shorter duration of SRL therapy before PEG were associated with increased risk of tumor growth [45]. Changes in tumor size seem not to correlate with IGF-I levels [48].…”

Section: Global Clinical Effectsmentioning

confidence: 99%

Pegvisomant in acromegaly: an update

Giustina

Arnaldi

Bogazzi

et al. 2017

J Endocrinol Invest

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BackgroundIn 2007, we published an opinion document to review the role of pegvisomant (PEG) in the treatment of acromegaly. Since then, new evidence emerged on the biochemical and clinical effects of PEG and on its long-term efficacy and safety.AimWe here reviewed the emerging aspects of the use of PEG in clinical practice in the light of the most recent literature.ResultsThe clinical use of PEG is still suboptimal, considering that it remains the most powerful tool to control IGF-I in acromegaly allowing to obtain, with a pharmacological treatment, the most important clinical effects in terms of signs and symptoms, quality of life and comorbidities. The number of patients with acromegaly exposed to PEG worldwide has become quite elevated and the prolonged follow-up allows now to deal quite satisfactorily with many clinical issues including major safety issues, such as the concerns about possible tumour (re)growth under PEG. The positive or neutral impact of PEG on glucose metabolism has been highlighted, and the clinical experience, although limited, with sleep apnoea and pregnancy has been reviewed. Finally, the current concept of somatostatin receptor ligands (SRL) resistance has been addressed, in order to better define the acromegaly patients to whom the PEG option may be offered.ConclusionsPEG increasingly appears to be an effective and safe medical option for many patients not controlled by SRL but its use still needs to be optimized.

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“…Patients who continued treatment during pregnancy were even fewer. Daily pegvisomant dose at conception varied widely (14-40 mg), but mean dose was 15.3 mg/day, which is not very different from that used in most patients in observational studies [10,13]. Interestingly, a few patients were also taking SRLs at the time of conception.…”

mentioning

confidence: 94%

“…pregnant, most reports recommend stopping all medical treatment for acromegaly [5,9,10] and restarting only if severe symptoms (headache for example), visual changes, or tumor growth are present. Interestingly, acromegaly symptoms usually improve during pregnancy.…”

mentioning

confidence: 99%

Medical treatment of acromegaly in pregnancy, highlights on new reports

Fleseriu

2015

Endocrine

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Optimal use of pegvisomant in acromegaly: are we getting there?

Cited by 24 publications

References 59 publications

Prediction of therapy response in acromegalic patients under pegvisomant therapy within the German ACROSTUDY cohort

Prediction of therapy response in acromegalic patients under pegvisomant therapy within the German ACROSTUDY cohort

Pegvisomant in acromegaly: an update

Medical treatment of acromegaly in pregnancy, highlights on new reports

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