Self-limited acute hepatotoxicity caused by pegvisomant

Moreno, Antonio Barranco; Vázquez, Rodríguez; Moreno, Eva Venegas; Milla, Samara Palma; Castaño, Justo P.; Cerro, Alfonso Leal

doi:10.1007/s11102-009-0173-3

Cited by 7 publications

(3 citation statements)

References 16 publications

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“…9 The adverse events most frequently attributed to pegvisomant are disturbed liver function tests and injection site reactions. 106 Lipodistrophy 18,93 and acute hepatotoxicity 100 have also been reported. Pegvisomant is unique in that the drug does not lower GH levels-in fact, levels are raised due to feedback mechanics-thus making IGF-I the only available marker for disease activity.…”

Section: Growth Hormone Receptor Antagonistmentioning

confidence: 98%

Acromegaly: a review of current medical therapy and new drugs on the horizon

Fleseriu

Delashaw²,

Cook

2010

FOC

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Acromegaly is a disease that results from a growth hormone (GH)–secreting pituitary tumor. Clinically, the disease is characterized by excessive skeletal growth, soft tissue enlargement with disfigurement, and increased risk of cardiovascular death. The goals of treatment are the removal or reduction of the tumor mass via surgery and normalization of GH secretion. Another treatment goal is the preservation of normal pituitary function if possible. Transsphenoidal surgery by an experienced neurosurgeon is usually the first line of therapy, especially for small tumors. Surgeon expertise is crucial for outcome, with dedicated pituitary surgeons having better results. However, overall cure rates remain low because patients with these tumors usually present at an incurable stage. Therefore, medical therapy to control excess GH secretion plays a significant role in a large proportion of patients with acromegaly who are not cured by surgery or other forms of therapy, such as radiotherapy, and/or are awaiting the effects of radiotherapy. If surgery is not curative, lifelong monitoring and the control of excess GH is usually necessary by a care team experienced in handling this chronic disease. In the past decade major progress has occurred in the development of highly specific and selective pharmacological agents that have greatly facilitated more aggressive management of active acromegaly. Treatment approach should be individualized and take into consideration a patient's tumor size and location, symptoms, comorbid conditions, and preferences. Because a surgical cure can be difficult to achieve, all patients, even those with what seems to be a clinically and biochemically inactive disease, should undergo long-term biochemical testing and pituitary MR imaging.

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Section: Growth Hormone Receptor Antagonistmentioning

confidence: 98%

Acromegaly: a review of current medical therapy and new drugs on the horizon

Fleseriu

Delashaw²,

Cook

2010

FOC

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“…of TET 2 a F 44 2.2 15 mg daily NA NA NA 11.1 20.8 Drug withdrawn, norm. of TET Soto Moreno et al [ 57 ] 1 F 31 1.5 10 mg daily 0.3 0.3 1.4 117 80 Drug continued, norm. of TET Neggers et al [ 12 ] 1 M 41 61.9 30 mg weekly 0.7 0.6 2.0 4.0 4.7 Drug continued, norm.…”

Section: Side Effectsmentioning

confidence: 99%

Combined treatment of somatostatin analogues with pegvisomant in acromegaly

et al. 2015

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Treatment of acromegaly with monotherapy long-acting somatostatin analogues (LA-SSA) as primary treatment or after neurosurgery can only achieve complete normalization of insulin-like growth factor I (IGF-I) in roughly 40 % of patients. Recently, one of the acromegaly consensus groups has recommended switching to combined treatment of LA-SSA and pegvisomant (PEGV) in patients with partial response to LA-SSAs. This combination of LA-SSA and PEGV, a growth hormone receptor antagonist, can normalize IGF-I levels in virtually all patients, requiring that the adequate dose of PEGV is used. The required PEGV dose varies significantly between individual acromegaly patients. One of the advantages of the combination therapy is that tumor size control or even tumor shrinkage can be observed in a vast majority of patients. The main side effects of the combination treatment are gastrointestinal symptoms, lipohypertrophy and transient elevated liver transaminases. In this review we provide an overview of the efficacy and safety of the combined treatment of LA-SSAs with PEGV.

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“…An increase in liver enzymes has been observed and is reversible after ending treatment with Pegvisomant [192]. Small increases in transaminases (>3 times upper limit of normal, N = 20) normalised spontaneously in 10/20 patients despite ongoing therapy [193].…”

Section: Options For Medical Therapymentioning

confidence: 99%

Medical Therapy of Acromegaly

Plöckinger

2012

International Journal of Endocrinology

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This paper outlines the present status of medical therapy of acromegaly. Indications for permanent postoperative treatment, postirradiation treamtent to bridge the interval until remission as well as primary medical therapy are elaborated. Therapeutic efficacy of the different available drugs—somatostatin receptor ligands (SRLs), dopamine agonists, and the GH antagonist Pegvisomant—is discussed, as are the indications for and efficacy of their respective combinations. Information on their mechanism of action, and some pharmakokinetic data are included. Special emphasis is given to the difficulties to define remission criteria of acromegaly due to technical assay problems. An algorithm for medical therapy in acromegaly is provided.

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Self-limited acute hepatotoxicity caused by pegvisomant

Cited by 7 publications

References 16 publications

Acromegaly: a review of current medical therapy and new drugs on the horizon

Acromegaly: a review of current medical therapy and new drugs on the horizon

Combined treatment of somatostatin analogues with pegvisomant in acromegaly

Medical Therapy of Acromegaly

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