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    Successful use of weekly pegvisomant administration in patients with acromegaly.

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    [1479683X - European Journal of ...
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    Authors
    Higham, Claire E
    Thomas, J
    Bidlingmaier, M
    Drake, William M
    Trainer, Peter J
    Affiliation
    C Higham, Endocrinology, Christie Hospital, Manchester, M20 4BX, United Kingdom.
    Issue Date
    2009-05-01
    
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    Abstract
    Context Clinical trials using 80 mg once-weekly pegvisomant in active acromegaly led to a 30% fall in serum IGF-I. Subsequent studies demonstrated that daily administration of up to 40 mg/day achieved an IGF-I within reference range in 97% of patients. Pegvisomant has a half-life of >70hrs suggesting weekly dosing may be possible but using higher doses than in the initial trials. Objective To determine the efficacy of weekly dosing of pegvisomant. Design A two-center, open-label prospective study in patients with acromegaly converted from a stable daily dose of pegvisomant (median dose 15 mg daily [range 10-20 mg od], IGF-I normal for 3 months prior to inclusion) to twice-weekly (week 0-16) followed by once-weekly (week 16-32) administration. Results Seven patients (4M, age 57+/-7 yrs, 6/7 prior trans-sphenoidal surgery, 7/7 prior radiotherapy) were recruited. Six patients completed the twice-weekly and five patients both the twice-weekly and once-weekly administration. Headaches led to 2 patient withdrawals at 0 + 24 weeks. Mean pre-dose serum IGF-I levels remained stable with the different administration regimens (IGF-I baseline 145+/-39 ng/ml, twice-weekly 124+/-39 ng/ml and once-weekly 127+/-22 ng/ml) and all values were within age adjusted IGF-I reference range. Pegvisomant dose was reduced in 2 patients and 5 opted to continue weekly administration at trial termination. Safety and QOL parameters remained stable. Conclusions Twice and once-weekly administration of pegvisomant is effective in controlling serum IGF-I levels in acromegaly and although not formally assessed, continuation of weekly dosing in 5 patients at study conclusion suggests patient preference for this regimen.
    Citation
    Successful use of weekly pegvisomant administration in patients with acromegaly. 2009: Eur. J. Endocrinol.
    Journal
    European Journal of Endocrinology
    URI
    http://hdl.handle.net/10541/69755
    DOI
    10.1530/EJE-08-0990
    PubMed ID
    19411301
    Type
    Article
    Language
    en
    ISSN
    1479-683X
    ae974a485f413a2113503eed53cd6c53
    10.1530/EJE-08-0990
    Scopus Count
    Collections
    All Christie Publications
    Endocrinology

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