Long-term experience of pegvisomant therapy as a treatment for acromegaly.

2.50
Hdl Handle:
http://hdl.handle.net/10541/81978
Title:
Long-term experience of pegvisomant therapy as a treatment for acromegaly.
Authors:
Higham, Claire E ( 0000-0002-0917-9743 ) ; Chung, T T; Lawrance, Jeremy A L; Drake, William M; Trainer, Peter J
Abstract:
AIMS: To evaluate the long-term efficacy and safety of pegvisomant as a treatment for acromegaly. DESIGN: Retrospective analysis of clinical and trial data from all patients treated with pegvisomant since 1997 at two centres with common protocols. RESULTS: Fifty-seven patients (age range 27-78 years) have been treated with pegvisomant since 1997 for up to 91 months (median 18 months). Before commencing pegvisomant, patients had an IGF-I above the upper limit of normal (ULN) of the age-related reference range (median 1.8 x ULN, range 1.2-4.1). Ninety-five per cent normalized IGF-I using a median dose of 15 mg daily (range 10 mg alternate day to 60 mg daily) with no influence of gender on dose requirement. Five patients had combination therapy with either somatostatin analogues (SSA) or cabergoline. Two patients initially controlled on 10 mg and 20 mg required dose increases (to 20 mg + 40 mg) over 24 months to reduce IGF-I. Twenty-seven patients stopped pegvisomant. Reasons included side-effects [abnormal liver function tests (LFTs)] and patient choice. Two patients developed elevated liver transaminases, which normalized on stopping pegvisomant. Patients had 6-12-monthly pituitary magnetic resonance imaging (MRI) scans. One patient had significant tumour size increase. CONCLUSION: This long-term experience in 57 patients indicates pegvisomant to be effective, safe and well-tolerated. Raised transaminases occurred within the first month of therapy in two patients, and tumour growth was seen in one patient (tumour was growing prior to pegvisomant). In two patients increasing doses of pegvisomant were required to keep IGF-I within the target range.
Affiliation:
Department of Endocrinology, Christie Hospital, Manchester, UK.
Citation:
Long-term experience of pegvisomant therapy as a treatment for acromegaly. 2009, 71 (1):86-91 Clin. Endocrinol.
Journal:
Clinical Endocrinology
Issue Date:
Jul-2009
URI:
http://hdl.handle.net/10541/81978
DOI:
10.1111/j.1365-2265.2008.03469.x
PubMed ID:
19018786
Type:
Article
Language:
en
ISSN:
1365-2265
Appears in Collections:
All Christie Publications ; Endocrinology

Full metadata record

DC FieldValue Language
dc.contributor.authorHigham, Claire E-
dc.contributor.authorChung, T T-
dc.contributor.authorLawrance, Jeremy A L-
dc.contributor.authorDrake, William M-
dc.contributor.authorTrainer, Peter J-
dc.date.accessioned2009-09-22T09:29:58Z-
dc.date.available2009-09-22T09:29:58Z-
dc.date.issued2009-07-
dc.identifier.citationLong-term experience of pegvisomant therapy as a treatment for acromegaly. 2009, 71 (1):86-91 Clin. Endocrinol.en
dc.identifier.issn1365-2265-
dc.identifier.pmid19018786-
dc.identifier.doi10.1111/j.1365-2265.2008.03469.x-
dc.identifier.urihttp://hdl.handle.net/10541/81978-
dc.description.abstractAIMS: To evaluate the long-term efficacy and safety of pegvisomant as a treatment for acromegaly. DESIGN: Retrospective analysis of clinical and trial data from all patients treated with pegvisomant since 1997 at two centres with common protocols. RESULTS: Fifty-seven patients (age range 27-78 years) have been treated with pegvisomant since 1997 for up to 91 months (median 18 months). Before commencing pegvisomant, patients had an IGF-I above the upper limit of normal (ULN) of the age-related reference range (median 1.8 x ULN, range 1.2-4.1). Ninety-five per cent normalized IGF-I using a median dose of 15 mg daily (range 10 mg alternate day to 60 mg daily) with no influence of gender on dose requirement. Five patients had combination therapy with either somatostatin analogues (SSA) or cabergoline. Two patients initially controlled on 10 mg and 20 mg required dose increases (to 20 mg + 40 mg) over 24 months to reduce IGF-I. Twenty-seven patients stopped pegvisomant. Reasons included side-effects [abnormal liver function tests (LFTs)] and patient choice. Two patients developed elevated liver transaminases, which normalized on stopping pegvisomant. Patients had 6-12-monthly pituitary magnetic resonance imaging (MRI) scans. One patient had significant tumour size increase. CONCLUSION: This long-term experience in 57 patients indicates pegvisomant to be effective, safe and well-tolerated. Raised transaminases occurred within the first month of therapy in two patients, and tumour growth was seen in one patient (tumour was growing prior to pegvisomant). In two patients increasing doses of pegvisomant were required to keep IGF-I within the target range.en
dc.language.isoenen
dc.subjectPegvisomanten
dc.subjectAcromegalyen
dc.subjectTreatment Optionsen
dc.subjectTreatment Evaluationen
dc.titleLong-term experience of pegvisomant therapy as a treatment for acromegaly.en
dc.typeArticleen
dc.contributor.departmentDepartment of Endocrinology, Christie Hospital, Manchester, UK.en
dc.identifier.journalClinical Endocrinologyen

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