BACKGROUND: The competitive GH receptor antagonist pegvisomant is reported to normalise IGF-1 levels in up to 97 % of acromegalic patients at a maximum dosage of 40 mg/d. Description of Case: We present an acromegalic patient resistant to the recommended maximum GH receptor antagonist dosage. The 60-year-old male patient presenting with typical clinical signs of acromegaly has underwent multiple transsphenoidal surgeries and pituitary irradiation, while currently available pharmacological therapies for acromegaly have been exhausted. RESULTS: Biochemical control of the disease could only be achieved until uptitration of pegvisomant to 60 mg/d which was tolerated well. CONCLUSIONS: The current treatment algorithm for acromegaly should be modified to treat cases of persistent and uncontrolled disease.
BACKGROUND: The competitive GH receptor antagonist pegvisomant is reported to normalise IGF-1 levels in up to 97 % of acromegalicpatients at a maximum dosage of 40 mg/d. Description of Case: We present an acromegalicpatient resistant to the recommended maximum GH receptor antagonist dosage. The 60-year-old male patient presenting with typical clinical signs of acromegaly has underwent multiple transsphenoidal surgeries and pituitary irradiation, while currently available pharmacological therapies for acromegaly have been exhausted. RESULTS: Biochemical control of the disease could only be achieved until uptitration of pegvisomant to 60 mg/d which was tolerated well. CONCLUSIONS: The current treatment algorithm for acromegaly should be modified to treat cases of persistent and uncontrolled disease.
Authors: P J Trainer; W M Drake; L Katznelson; P U Freda; V Herman-Bonert; A J van der Lely; E V Dimaraki; P M Stewart; K E Friend; M L Vance; G M Besser; J A Scarlett; M O Thorner; C Parkinson; A Klibanski; J S Powell; A L Barkan; M C Sheppard; M Malsonado; D R Rose; D R Clemmons; G Johannsson; B A Bengtsson; S Stavrou; D L Kleinberg; D M Cook; L S Phillips; M Bidlingmaier; C J Strasburger; S Hackett; K Zib; W F Bennett; R J Davis Journal: N Engl J Med Date: 2000-04-20 Impact factor: 91.245
Authors: David R Clemmons; Kazuo Chihara; Pamela U Freda; Ken K Y Ho; Anne Klibanski; Shlomo Melmed; Stephen M Shalet; Christian J Strasburger; Peter J Trainer; Michael O Thorner Journal: J Clin Endocrinol Metab Date: 2003-10 Impact factor: 5.958
Authors: Annamaria Colao; Rosario Pivonello; Renata S Auriemma; Maria Cristina De Martino; Martin Bidlingmaier; Francesco Briganti; Fabio Tortora; Pia Burman; Ione A Kourides; Christian J Strasburger; Gaetano Lombardi Journal: Eur J Endocrinol Date: 2006-03 Impact factor: 6.664
Authors: S Melmed; A Colao; A Barkan; M Molitch; A B Grossman; D Kleinberg; D Clemmons; P Chanson; E Laws; J Schlechte; M L Vance; K Ho; A Giustina Journal: J Clin Endocrinol Metab Date: 2009-02-10 Impact factor: 5.958