Acromegaly: a new therapy.
BACKGROUND
The treatment of acromegaly can be challenging. Despite a multimodality approach (surgery,radiation, dopamine agonists, somatostatin analogs), many patients do not achieve normalization of serum insulin-like growth factor I (IGF-I) concentrations.


METHODS
The author discusses the characteristics and indications of pegvisomant therapy for patients with acromegaly and compares the use of this newly developed GH receptor antagonist with other pharmacological agents such as somatostatin and dopamine agonists.


RESULTS
Therapy with pegvisomant allows serum IGF-I concentrations to be normalized in up to 97% of patients with acromegaly, including those who have failed other treatment modalities. With this agent,circulating GH levels increase as a result of the drop in IGF-I levels. The rise is rapid (within 2 weeks) and does not appear to be progressive over time.


CONCLUSIONS
Published studies have shown pegvisomant to have efficacy in the treatment of acromegaly. As it appears to be well tolerated and safe, this novel compound may be an important therapeutic option for patients with acromegaly. Additional study of this novel agent and its mode of action is warranted.
Friend
Keith E
KE
Pharmacia Corp, Peapack, NJ 07977, USA. Keith.Friend@pharmacia.com
D000172:Acromegaly / Q000188:drug therapy*; D018491:Dopamine Agonists / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000187:drug effects; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use
D018491:Dopamine Agonists; D019382:Human Growth Hormone; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; C406545:pegvisomant