|ATC code||H01AX01 (WHO)|
|Molar mass||22129.0 g/mol (unpegylated)|
|(what is this?)|
Pegvisomant (trade name Somavert) is a growth hormone receptor antagonist used in the treatment of acromegaly. It is used if the tumor of the pituitary gland causing the acromegaly cannot be controlled with surgery or radiation, and the use of somatostatin analogues is unsuccessful. It is delivered as a powder that is mixed with water and injected under the skin.
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. The polyethylene glycol polymers are subsequently added chemically.
Mechanism of action
Pegvisomant blocks the action of growth hormone at the growth hormone receptor to reduce the production of IGF-1. IGF-1 is responsible for most of the symptoms of acromegaly. Normalising its levels may control the symptoms. However, there is no strong evidence that it improves quality of life or survival.
Blocking of the growth hormone's receptor reduces feedback control of the growth hormone regulation leading to approximately doubled GH levels.
- Schreiber, I; Buchfelder M; Droste M; et al. (January 2007). "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 (Bioscientifica) 156 (1): 75–82. doi:10.1530/eje.1.02312. PMID 17218728.
- "Scientific Discussion of Somavert" (PDF). European Medicines Agency. 2004.
- Kopchick, JJ (2003). "Discovery and mechanism of action of pegvisomant". European Journal of Endocrinology 148 (Suppl 2): S21–5. doi:10.1530/eje.0.148s021. PMID 12670297.
- Berryman, DE; Palmer, AJ; Gosney, ES; Swaminathan, S; Desantis, D; Kopchick, JJ (2007). "Discovery and uses of pegvisomant: A growth hormone antagonist". Endokrynologia Polska 58 (4): 322–9. PMID 18058724.
- Canadian Agency for Drugs and Technologies in Health, CEDAC Final REcommendation on Reconsideration and Reasons for Recommendation, Pegvisomant (Somavert - Pfizer Canda Inc.)
- Feenstra, J; Van Aken, MO; De Herder, WW; Feelders, RA; Van Der Lely, AJ (2006). "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): 805–806. doi:10.1530/eje.1.02160. PMID 16728538.
- Moore, D.; Adi, Y.; Connock, M.; Bayliss, S. (2009). "Clinical effectiveness and cost-effectiveness of pegvisomant for the treatment of acromegaly: a systematic review and economic evaluation". BMC endocrine disorders 9: 20. doi:10.1186/1472-6823-9-20. PMC 2768727. PMID 19814797.