Pegvisomant in the treatment of acromegaly

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Abstract

Acromegaly is a rare severe disease characterized by excess production of growth hormone in individuals with closed growth plates, associated with a number of comorbid conditions, high levels of disability and mortality. Surgical, radiation and drug methods are used to treat acromegaly. The emergence of new drugs makes it possible to improve the results of treatment of acromegaly and reduce the severity of associated diseases, which helps reduce mortality and improve the quality of life of patients. Pegvisomant is a growth hormone receptor blocker and is currently the most effective drug for acromegaly treatment. Most often, the drug is used as a second-line treatment for patients with resistance to somatostatin analogues. Pegvisomant may be the drug of choice for monotherapy in patients in whom the severity of the disease requires rapid normalization of the insulin-like growth factor 1 (IGF-1) level, as well as in cases where diabetes mellitus is not stable due to the positive effect of the drug on carbohydrate metabolism and a decrease in insulin resistance. Combination therapy with growth hormone receptor antagonists and somatostatin analogues is a promising direction due to the increased effectiveness of treatment with the combined action of drugs, especially in terms of reducing the tumor mass of the pituitary gland, as well as reducing the cost of treatment by reducing the dosage of pegvisomant.

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About the authors

D. V. Rebrova

St. Petersburg State University, Pirogov Clinic of High Medical Technologies

Author for correspondence.
Email: endocrinology@list.ru
ORCID iD: 0000-0002-7840-4174
SPIN-code: 6284-9008
Scopus Author ID: 57195152806
ResearcherId: AHD-5099-2022

Cand. Sci. (Med.), Endocrinologist, Department of Endocrine Surgery

Russian Federation, St. Petersburg

N. V. Vorokhobina

North-Western State Medical University n.a. I.I. Mechnikov

Email: endocrinology@list.ru
ORCID iD: 0000-0002-9574-105X
SPIN-code: 4062-6409
Russian Federation, St. Petersburg

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