The role of growth hormone-receptor antagonism in relation to acromegaly.
Acromegaly is a rare but disabling condition associated with reduced life expectancy. It is caused almost invariably by a growth hormone-secreting pituitary adenoma. Transsphenoidal surgery and/or radiotherapy are still considered to be the treatment of choice, but despite recent advances in both these forms of treatment, the overall surgical cure rate remains approximately 60%, and radiotherapy is characterised by delayed effect and a high incidence of hypopituitarism. Medical therapy in the form of dopamine agonists and somatostatin analogues has traditionally been used as an adjunct to surgery and/or radiotherapy, but is increasingly being used as first line therapy in the treatment of acromegaly. Recently, a third form of medical therapy, the growth hormone receptor antagonist, pegvisomant, has been licensed for use in acromegaly. This article examines the design, properties, clinical efficacy and safety of pegvisomant.
Ayuk
John
J
Division of Medical Sciences, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, UK.
Sheppard
Michael C
MC
D000172:Acromegaly / Q000188:drug therapy* / Q000378:metabolism; D015195:Drug Design; D019382:Human Growth Hormone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D011986:Receptors, Somatotropin / Q000037:antagonists & inhibitors*
D011986:Receptors, Somatotropin; D019382:Human Growth Hormone; C406545:pegvisomant