Pegvisomant Explained

Pegvisomant, sold under the brand name Somavert, is a growth hormone receptor antagonist used in the treatment of acromegaly.[1] It is primarily used if the pituitary gland tumor causing the acromegaly cannot be controlled with surgery or radiation, and the use of somatostatin analogues is unsuccessful, but is also effective as a monotherapy.[2] It is delivered as a powder that is mixed with water and injected under the skin.[3]

Medical uses

Pegvisomant is indicated for the treatment of adults with acromegaly.

Side effects

Side effects of pegvisomant include reactions at the injection site, swelling of the limbs, chest pain, hypoglycemia, nausea and hepatitis.[4]

Discovery

Pegvisomant was discovered at Ohio University in 1987 by Distinguished Professor John Kopchick and graduate student Wen Chen at the Edison Biotechnology Institute. After completing clinical trials, it was approved for the treatment of acromegaly by the FDA in 2003 and marketed by Pfizer.[5]

Structure

Pegvisomant is a protein containing 191 amino acid residues to which several polyethylene glycol polymers have been covalently bound in order to slow clearance from the blood. The protein is a modified version of human growth hormone designed to bind to and block the growth hormone receptor. It is manufactured using genetically modified E. coli bacteria.

Mechanism of action

Pegvisomant blocks the action of growth hormone on the growth hormone receptor to reduce the production of IGF-1.[6] [7] IGF-1 is responsible for most of the symptoms of acromegaly, and the normalization of its levels can control the symptoms.[8]

Long-term treatment studies with pegvisomant as a monotherapy have shown it to be safe,[2] and effective.[9]

Research

Some studies show the potential of using pegvisomant as an anti-tumor treatment for certain types of cancers.[10] [11]

External links

Notes and References

  1. Schreiber I, Buchfelder M, Droste M, Forssmann K, Mann K, Saller B, Strasburger CJ . Treatment of acromegaly with the GH receptor antagonist pegvisomant in clinical practice: safety and efficacy evaluation from the German Pegvisomant Observational Study . European Journal of Endocrinology . 156 . 1 . 75–82 . January 2007 . 17218728 . 10.1530/eje.1.02312 . 12121175 .
  2. Freda PU, Gordon MB, Kelepouris N, Jonsson P, Koltowska-Haggstrom M, van der Lely AJ . Long-term treatment with pegvisomant as monotherapy in patients with acromegaly: experience from ACROSTUDY . Endocrine Practice . 21 . 3 . 264–74 . March 2015 . 25370326 . 4618502 . 10.4158/EP14330.OR .
  3. Scientific Discussion of Somavert. 2004. European Medicines Agency. 17 February 2011. 18 June 2018. https://web.archive.org/web/20180618111805/http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000409/WC500054625.pdf. dead.
  4. Feenstra J, van Aken MO, de Herder WW, Feelders RA, van der Lely AJ . Drug-induced hepatitis in an acromegalic patient during combined treatment with pegvisomant and octreotide long-acting repeatable attributed to the use of pegvisomant . European Journal of Endocrinology . 154 . 6 . 805–6 . June 2006 . 16728538 . 10.1530/eje.1.02160 . free .
  5. Web site: Ohio University, inventors to receive up to $52 million from drug license transactions. 15 February 2011. Ohio University. 21 November 2016. 22 November 2016. https://web.archive.org/web/20161122072549/https://www.ohio.edu/research/communications/royaltymonetization.cfm. dead.
  6. Kopchick JJ . Discovery and mechanism of action of pegvisomant . European Journal of Endocrinology . 148 . S21-5 . April 2003 . Suppl 2 . 12670297 . 10.1530/eje.0.148s021 . free .
  7. Berryman DE, Palmer AJ, Gosney ES, Swaminathan S, DeSantis D, Kopchick JJ . Discovery and uses of pegvisomant: a growth hormone antagonist . Endokrynologia Polska . 58 . 4 . 322–9 . 2007 . 18058724 .
  8. CEDAC Final REcommendation on Reconsideration and Reasons for Recommendation: Pegvisomant (Somavert - Pfizer Canada Inc.). Canadian Agency for Drugs and Technologies in Health. 2 August 2006. 22 December 2014. 28 June 2021. https://web.archive.org/web/20210628192115/https://www.cadth.ca/media/cdr/complete/cdr_complete_Somavert_%20August2_2006.pdf. dead.
  9. Neggers SJ, Muhammad A, van der Lely AJ . Pegvisomant Treatment in Acromegaly . Neuroendocrinology . 103 . 1 . 59–65 . 2015 . 25792221 . 10.1159/000381644 . 19588354 . free .
  10. Evans A, Jamieson SM, Liu DX, Wilson WR, Perry JK . Growth hormone receptor antagonism suppresses tumour regrowth after radiotherapy in an endometrial cancer xenograft model . Cancer Letters . 379 . 1 . 117–23 . August 2016 . 27241667 . 10.1016/j.canlet.2016.05.031 . 2292/30976 . free .
  11. Divisova J, Kuiatse I, Lazard Z, Weiss H, Vreeland F, Hadsell DL, Schiff R, Osborne CK, Lee AV . 6 . The growth hormone receptor antagonist pegvisomant blocks both mammary gland development and MCF-7 breast cancer xenograft growth . Breast Cancer Research and Treatment . 98 . 3 . 315–27 . August 2006 . 16541323 . 10.1007/s10549-006-9168-1 . 6234700 .

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