Combined therapy with somatostatin analogues and weekly pegvisomant in active acromegaly

Lancet. 2005 May 7-13;365(9471):1644-6. doi: 10.1016/S0140-6736(05)63011-5.

Abstract

Pegvisomant monotherapy once daily returns concentrations of insulin-like growth factor I (IGF-I) to normal in most patients with acromegaly, but is very costly. In a 42-week dose-finding study, we assessed the efficacy of the combination of long-acting somatostatin analogues once monthly and pegvisomant once weekly in 26 patients with active acromegaly. Dose of pegvisomant was increased until IGF-I concentration became normal or until a weekly dose of 80 mg was reached. IGF-I reached normal concentrations in 18 of 19 (95%) patients who completed 42 weeks of treatment, with a median weekly dose of 60 mg pegvisomant (range 40-80). No signs of pituitary tumour growth were noted, but mild increases in liver enzymes were observed in ten patients (38%). This combined treatment is effective, might increase compliance, and could greatly reduce the costs of medical treatment for acromegaly in some patients.

Publication types

  • Clinical Trial

MeSH terms

  • Acromegaly / blood
  • Acromegaly / drug therapy*
  • Adult
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Delayed-Action Preparations
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Human Growth Hormone / administration & dosage*
  • Human Growth Hormone / analogs & derivatives*
  • Humans
  • Insulin-Like Growth Factor I / analysis
  • Male
  • Middle Aged
  • Octreotide / administration & dosage*
  • Peptides, Cyclic / administration & dosage*
  • Receptors, Somatotropin / antagonists & inhibitors*
  • Somatostatin / administration & dosage*
  • Somatostatin / analogs & derivatives*

Substances

  • Delayed-Action Preparations
  • Peptides, Cyclic
  • Receptors, Somatotropin
  • lanreotide
  • Human Growth Hormone
  • Somatostatin
  • Insulin-Like Growth Factor I
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • pegvisomant
  • Octreotide