当前位置： SCI文献检索 > EUROPEAN JOURNAL OF ENDOCRINOLOGY期刊下所有文献 > What is the efficacy of switching to weekly pegvisomant in acromegaly patients well controlled on combination therapy?

What is the efficacy of switching to weekly pegvisomant in acromegaly patients well controlled on combination therapy?

Abstract：

CONTEXT:Although combination therapy of acromegaly with long-acting somatostatin analogs (LA-SSAs) and pegvisomant (PEGV) normalizes insulin-like growth factor-1 (IGF1) levels in the majority of patients, it requires long-term adherence. Switching from combination therapy to monotherapy with weekly PEGV could improve patients' comfort, but the efficacy is unknown. OBJECTIVE:To assess the efficacy of switching to PEGV monotherapy in patients well controlled on combination therapy of LA-SSAs and PEGV. DESIGN:Single-center, open-label observational pilot study. LA-SSA therapy was discontinued at baseline and all patients were switched to PEGV monotherapy for 12 months. If IGF1 levels exceeded 1.0 times upper limit of normal (ULN), PEGV dose was increased by 20 mg weekly. SUBJECTS AND METHODS:The study included 15 subjects (eight males), with a median age of 58 years (range 35-80) on combination therapy of high-dose LA-SSAs and weekly PEGV for >6 months, and IGF1 levels within the normal range. Treatment efficacy was assessed by measuring serum IGF1 levels. RESULTS:After 12 months of weekly PEGV monotherapy, serum IGF1 levels of 73% of the subjects remained controlled. In one patient, LA-SSA had to be restarted due to recurrence of headache. IGF1 levels increased from a baseline level of 0.62 × ULN (range 0.30-0.84) to 0.83 × ULN (0.30-1.75) after 12 months, while the median weekly PEGV dose increased from 60 (30-80) mg to 80 (50-120) mg. CONCLUSION:Our results suggest that switching from combination therapy of LA-SSAs and PEGV to PEGV monotherapy can be a viable treatment option for acromegaly patients without compromising efficacy.

journal_name

Eur J Endocrinol

journal_title

European journal of endocrinology

authors

Muhammad A,van der Lely AJ,O'Connor RD,Delhanty PJ,Dal J,Dallenga AH,Feelders RA,Janssen JA,Jorgensen JO,Neggers SJ

doi

10.1530/EJE-15-1150

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

663-7

issue

5

eissn

0804-4643

issn

1479-683X

pii

EJE-15-1150

journal_volume

174

pub_type

杂志文章

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