Treatment of acromegaly with the growth hormone-receptor antagonist pegvisomant.

2.50
Hdl Handle:
http://hdl.handle.net/10541/82063
Title:
Treatment of acromegaly with the growth hormone-receptor antagonist pegvisomant.
Authors:
Trainer, Peter J; Drake, William M; Katznelson, L; Freda, P U; Herman-Bonert, V; Van der Lely, A J; Dimaraki, E V; Stewart, P M; Friend, K E; Vance, Mary Lee; Besser, G M; Scarlett, J A; Thorner, Michael O; Parkinson, Craig; Klibanski, Anne; Powell, J S; Barkan, Ariel L; Sheppard, M C; Malsonado, M; Rose, D R; Clemmons, David R; Johannsson, G; Bengtsson, B A; Stavrou, S; Kleinberg, David L; Cook, D M; Phillips, L S; Bidlingmaier, M; Strasburger, Christian J; Hackett, S; Zib, K A; Bennett, W F; Davis, R J
Abstract:
BACKGROUND: Patients with acromegaly are currently treated with surgery, radiation therapy, and drugs to reduce hypersecretion of growth hormone, but the treatments may be ineffective and have adverse effects. Pegvisomant is a genetically engineered growth hormone-receptor antagonist that blocks the action of growth hormone. METHODS: We conducted a 12-week, randomized, double-blind study of three daily doses of pegvisomant (10 mg, 15 mg, and 20 mg) and placebo, given subcutaneously, in 112 patients with acromegaly. RESULTS: The mean (+/-SD) serum concentration of insulin-like growth factor I (IGF-I) decreased from base line by 4.0+/-16.8 percent in the placebo group, 26.7+/-27.9 percent in the group that received 10 mg of pegvisomant per day, 50.1+/-26.7 percent in the group that received 15 mg of pegvisomant per day, and 62.5+/-21.3 percent in the group that received 20 mg of pegvisomant per day (P<0.001 for the comparison of each pegvisomant group with placebo), and the concentrations became normal in 10 percent, 54 percent, 81 percent, and 89 percent of patients, respectively (P<0.001 for each comparison with placebo). Among patients treated with 15 mg or 20 mg of pegvisomant per day, there were significant decreases in ring size, soft-tissue swelling, the degree of excessive perspiration, and fatigue. The score fortotal symptoms and signs of acromegaly decreased significantly in all groups receiving pegvisomant (P< or =0.05). The incidence of adverse effects was similar in all groups. CONCLUSIONS: On the basis of these preliminary results, treatment of patients who have acromegaly with a growth hormone-receptor antagonist results in a reduction in serum IGF-I concentrations and in clinical improvement.
Affiliation:
Christie Hospital, Manchester, United Kingdom.
Citation:
Treatment of acromegaly with the growth hormone-receptor antagonist pegvisomant. 2000, 342 (16):1171-7 N. Engl. J. Med.
Journal:
The New England Journal of Medicine
Issue Date:
20-Apr-2000
URI:
http://hdl.handle.net/10541/82063
PubMed ID:
10770982
Type:
Article
Language:
en
ISSN:
0028-4793
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorTrainer, Peter J-
dc.contributor.authorDrake, William M-
dc.contributor.authorKatznelson, L-
dc.contributor.authorFreda, P U-
dc.contributor.authorHerman-Bonert, V-
dc.contributor.authorVan der Lely, A J-
dc.contributor.authorDimaraki, E V-
dc.contributor.authorStewart, P M-
dc.contributor.authorFriend, K E-
dc.contributor.authorVance, Mary Lee-
dc.contributor.authorBesser, G M-
dc.contributor.authorScarlett, J A-
dc.contributor.authorThorner, Michael O-
dc.contributor.authorParkinson, Craig-
dc.contributor.authorKlibanski, Anne-
dc.contributor.authorPowell, J S-
dc.contributor.authorBarkan, Ariel L-
dc.contributor.authorSheppard, M C-
dc.contributor.authorMalsonado, M-
dc.contributor.authorRose, D R-
dc.contributor.authorClemmons, David R-
dc.contributor.authorJohannsson, G-
dc.contributor.authorBengtsson, B A-
dc.contributor.authorStavrou, S-
dc.contributor.authorKleinberg, David L-
dc.contributor.authorCook, D M-
dc.contributor.authorPhillips, L S-
dc.contributor.authorBidlingmaier, M-
dc.contributor.authorStrasburger, Christian J-
dc.contributor.authorHackett, S-
dc.contributor.authorZib, K A-
dc.contributor.authorBennett, W F-
dc.contributor.authorDavis, R J-
dc.date.accessioned2009-09-22T11:53:23Z-
dc.date.available2009-09-22T11:53:23Z-
dc.date.issued2000-04-20-
dc.identifier.citationTreatment of acromegaly with the growth hormone-receptor antagonist pegvisomant. 2000, 342 (16):1171-7 N. Engl. J. Med.en
dc.identifier.issn0028-4793-
dc.identifier.pmid10770982-
dc.identifier.urihttp://hdl.handle.net/10541/82063-
dc.description.abstractBACKGROUND: Patients with acromegaly are currently treated with surgery, radiation therapy, and drugs to reduce hypersecretion of growth hormone, but the treatments may be ineffective and have adverse effects. Pegvisomant is a genetically engineered growth hormone-receptor antagonist that blocks the action of growth hormone. METHODS: We conducted a 12-week, randomized, double-blind study of three daily doses of pegvisomant (10 mg, 15 mg, and 20 mg) and placebo, given subcutaneously, in 112 patients with acromegaly. RESULTS: The mean (+/-SD) serum concentration of insulin-like growth factor I (IGF-I) decreased from base line by 4.0+/-16.8 percent in the placebo group, 26.7+/-27.9 percent in the group that received 10 mg of pegvisomant per day, 50.1+/-26.7 percent in the group that received 15 mg of pegvisomant per day, and 62.5+/-21.3 percent in the group that received 20 mg of pegvisomant per day (P<0.001 for the comparison of each pegvisomant group with placebo), and the concentrations became normal in 10 percent, 54 percent, 81 percent, and 89 percent of patients, respectively (P<0.001 for each comparison with placebo). Among patients treated with 15 mg or 20 mg of pegvisomant per day, there were significant decreases in ring size, soft-tissue swelling, the degree of excessive perspiration, and fatigue. The score fortotal symptoms and signs of acromegaly decreased significantly in all groups receiving pegvisomant (P< or =0.05). The incidence of adverse effects was similar in all groups. CONCLUSIONS: On the basis of these preliminary results, treatment of patients who have acromegaly with a growth hormone-receptor antagonist results in a reduction in serum IGF-I concentrations and in clinical improvement.en
dc.language.isoenen
dc.subjectPituitary Canceren
dc.subject.meshAcromegaly-
dc.subject.meshAdenoma-
dc.subject.meshAdult-
dc.subject.meshAutoantibodies-
dc.subject.meshDouble-Blind Method-
dc.subject.meshFemale-
dc.subject.meshHuman Growth Hormone-
dc.subject.meshHumans-
dc.subject.meshInsulin-Like Growth Factor I-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPituitary Neoplasms-
dc.subject.meshReceptors, Somatotropin-
dc.titleTreatment of acromegaly with the growth hormone-receptor antagonist pegvisomant.en
dc.typeArticleen
dc.contributor.departmentChristie Hospital, Manchester, United Kingdom.en
dc.identifier.journalThe New England Journal of Medicineen

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