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

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    Authors
    Higham, Claire E
    Chung, T T
    Lawrance, Jeremy A L
    Drake, William M
    Trainer, Peter J
    Affiliation
    Department of Endocrinology, Christie Hospital, Manchester, UK.
    Issue Date
    2009-07
    
    Metadata
    Show full item record
    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.
    Citation
    Long-term experience of pegvisomant therapy as a treatment for acromegaly. 2009, 71 (1):86-91 Clin. Endocrinol.
    Journal
    Clinical Endocrinology
    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
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1365-2265.2008.03469.x
    Scopus Count
    Collections
    All Christie Publications
    Endocrinology

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