TY - JOUR
T1 - Combined treatment of somatostatin analogues with pegvisomant in acromegaly
AU - Franck, S. E.
AU - Muhammad, A.
AU - van der Lely, A. J.
AU - Neggers, S. J.C.M.M.
N1 - Publisher Copyright:
© 2015, The Author(s).
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Treatment of acromegaly with monotherapy long-acting somatostatin analogues (LA-SSA) as primary treatment or after neurosurgery can only achieve complete normalization of insulin-like growth factor I (IGF-I) in roughly 40 % of patients. Recently, one of the acromegaly consensus groups has recommended switching to combined treatment of LA-SSA and pegvisomant (PEGV) in patients with partial response to LA-SSAs. This combination of LA-SSA and PEGV, a growth hormone receptor antagonist, can normalize IGF-I levels in virtually all patients, requiring that the adequate dose of PEGV is used. The required PEGV dose varies significantly between individual acromegaly patients. One of the advantages of the combination therapy is that tumor size control or even tumor shrinkage can be observed in a vast majority of patients. The main side effects of the combination treatment are gastrointestinal symptoms, lipohypertrophy and transient elevated liver transaminases. In this review we provide an overview of the efficacy and safety of the combined treatment of LA-SSAs with PEGV.
AB - Treatment of acromegaly with monotherapy long-acting somatostatin analogues (LA-SSA) as primary treatment or after neurosurgery can only achieve complete normalization of insulin-like growth factor I (IGF-I) in roughly 40 % of patients. Recently, one of the acromegaly consensus groups has recommended switching to combined treatment of LA-SSA and pegvisomant (PEGV) in patients with partial response to LA-SSAs. This combination of LA-SSA and PEGV, a growth hormone receptor antagonist, can normalize IGF-I levels in virtually all patients, requiring that the adequate dose of PEGV is used. The required PEGV dose varies significantly between individual acromegaly patients. One of the advantages of the combination therapy is that tumor size control or even tumor shrinkage can be observed in a vast majority of patients. The main side effects of the combination treatment are gastrointestinal symptoms, lipohypertrophy and transient elevated liver transaminases. In this review we provide an overview of the efficacy and safety of the combined treatment of LA-SSAs with PEGV.
KW - Acromegaly
KW - Growth hormone
KW - Growth hormone receptor antagonist
KW - Insulin-like growth factor I
KW - Pegvisomant
KW - Somatostatin analogues
UR - http://www.scopus.com/inward/record.url?scp=84949551630&partnerID=8YFLogxK
U2 - 10.1007/s12020-015-0810-8
DO - 10.1007/s12020-015-0810-8
M3 - Review article
C2 - 26661938
AN - SCOPUS:84949551630
SN - 1355-008X
VL - 52
SP - 206
EP - 213
JO - Endocrine
JF - Endocrine
IS - 2
ER -