Pegvisomant in acromegaly: an update

A. Giustina, G. Arnaldi, F. Bogazzi, S. Cannavò, A. Colao, L. De Marinis, E. De Menis, E. Degli Uberti, F. Giorgino, S. Grottoli, A. G. Lania, P. Maffei, R. Pivonello, E. Ghigo

Research output: Contribution to journalReview article

19 Citations (Scopus)

Abstract

© 2017, The Author(s). Background: In 2007, we published an opinion document to review the role of pegvisomant (PEG) in the treatment of acromegaly. Since then, new evidence emerged on the biochemical and clinical effects of PEG and on its long-term efficacy and safety. Aim: We here reviewed the emerging aspects of the use of PEG in clinical practice in the light of the most recent literature. Results: The clinical use of PEG is still suboptimal, considering that it remains the most powerful tool to control IGF-I in acromegaly allowing to obtain, with a pharmacological treatment, the most important clinical effects in terms of signs and symptoms, quality of life and comorbidities. The number of patients with acromegaly exposed to PEG worldwide has become quite elevated and the prolonged follow-up allows now to deal quite satisfactorily with many clinical issues including major safety issues, such as the concerns about possible tumour (re)growth under PEG. The positive or neutral impact of PEG on glucose metabolism has been highlighted, and the clinical experience, although limited, with sleep apnoea and pregnancy has been reviewed. Finally, the current concept of somatostatin receptor ligands (SRL) resistance has been addressed, in order to better define the acromegaly patients to whom the PEG option may be offered. Conclusions: PEG increasingly appears to be an effective and safe medical option for many patients not controlled by SRL but its use still needs to be optimized.
Original languageEnglish
Pages (from-to)577-589
Number of pages13
JournalJournal of Endocrinological Investigation
Volume40
Issue number6
DOIs
Publication statusPublished - Jun 1 2017

Fingerprint

Acromegaly
Somatostatin Receptors
Ligands
Safety
pegvisomant
Sleep Apnea Syndromes
Insulin-Like Growth Factor I
Signs and Symptoms
Comorbidity
Quality of Life
Pharmacology
Glucose
Pregnancy

Keywords

  • Acromegaly
  • IGF-I
  • Metabolic effects
  • Pegvisomant
  • Review
  • SRL resistance

Cite this

Giustina, A., Arnaldi, G., Bogazzi, F., Cannavò, S., Colao, A., De Marinis, L., ... Ghigo, E. (2017). Pegvisomant in acromegaly: an update. Journal of Endocrinological Investigation, 40(6), 577-589. https://doi.org/10.1007/s40618-017-0614-1

Pegvisomant in acromegaly: an update. / Giustina, A.; Arnaldi, G.; Bogazzi, F.; Cannavò, S.; Colao, A.; De Marinis, L.; De Menis, E.; Degli Uberti, E.; Giorgino, F.; Grottoli, S.; Lania, A. G.; Maffei, P.; Pivonello, R.; Ghigo, E.

In: Journal of Endocrinological Investigation, Vol. 40, No. 6, 01.06.2017, p. 577-589.

Research output: Contribution to journalReview article

Giustina, A, Arnaldi, G, Bogazzi, F, Cannavò, S, Colao, A, De Marinis, L, De Menis, E, Degli Uberti, E, Giorgino, F, Grottoli, S, Lania, AG, Maffei, P, Pivonello, R & Ghigo, E 2017, 'Pegvisomant in acromegaly: an update', Journal of Endocrinological Investigation, vol. 40, no. 6, pp. 577-589. https://doi.org/10.1007/s40618-017-0614-1
Giustina A, Arnaldi G, Bogazzi F, Cannavò S, Colao A, De Marinis L et al. Pegvisomant in acromegaly: an update. Journal of Endocrinological Investigation. 2017 Jun 1;40(6):577-589. https://doi.org/10.1007/s40618-017-0614-1
Giustina, A. ; Arnaldi, G. ; Bogazzi, F. ; Cannavò, S. ; Colao, A. ; De Marinis, L. ; De Menis, E. ; Degli Uberti, E. ; Giorgino, F. ; Grottoli, S. ; Lania, A. G. ; Maffei, P. ; Pivonello, R. ; Ghigo, E. / Pegvisomant in acromegaly: an update. In: Journal of Endocrinological Investigation. 2017 ; Vol. 40, No. 6. pp. 577-589.
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