scholarly journals Octreotide long-acting repeatable and lanreotide Autogel are equally effective in controlling growth hormone secretion in acromegalic patients

2004 ◽  
pp. 489-495 ◽  
Author(s):  
SW van Thiel ◽  
JA Romijn ◽  
NR Biermasz ◽  
BE Ballieux ◽  
M Frolich ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Binding Affinity ◽  
Receptor Subtype ◽  
Somatostatin Analogue ◽  
Deconvolution Analysis ◽  
Octreotide Lar ◽  
Gh Secretion ◽  
Igf I ◽  
Long Acting ◽  
Lanreotide Autogel

OBJECTIVE: Recently a new depot preparation of the long-acting somatostatin analogue, lanreotide Autogel was introduced for the treatment of acromegaly. Like octreotide long-acting repeatable (LAR), it has high binding affinity for the somatostatin receptor subtype SSTR 2 and less binding affinity for SSTR 5. We hypothesized that the ability to suppress growth hormone (GH) secretion in patients with acromegaly would be similar for these depot preparations. PATIENTS AND STUDY DESIGN: Seven patients (mean age+/-S.E.M. 48.4+/-7 years) on long-term octreotide LAR treatment at a monthly injection interval for a mean of 2.8 years were enrolled in the study. They underwent a GH secretory profile study with 10 min sampling for 24 h, 28 days after an injection. At 2, 4 and 6 weeks after the next injection fasting GH profiles (every 30 min for 3.5 h) and serum IGF-I measurements were measured. These investigations were repeated 12 months later, when the patients were on an individually titrated stable dose of lanreotide Autogel. RESULTS: Secretory characteristics and total 24 h GH secretion, estimated by deconvolution analysis of the 10 min 24 h plasma GH concentrations, did not show differences between these two long-acting somatostatin analogues. Both drugs were equally effective in GH and IGF-I suppression as measured at 2, 4 and also at 6 weeks following an injection. CONCLUSION: The efficacy of lanreotide Autogel and octreotide LAR was equal, notwithstanding that these drugs are administered in a different way and have different pharmacokinetics.

Continuous subcutaneous octreotide infusion markedly suppresses IGF-I levels whilst only partially suppressing GH secretion in diabetics with retinopathy

1989 ◽  
Vol 120 (2) ◽  
pp. 187-194 ◽  
Author(s):  
S. L. Hyer ◽  
P. S. Sharp ◽  
R. A. Brooks ◽  
J. M. Burrin ◽  
E. M. Kohner
Keyword(s):  
Normal Subjects ◽  
High Plasma ◽  
Prolonged Treatment ◽  
Somatostatin Analogue ◽  
Clinical Value ◽  
Gh Secretion ◽  
Treatment Regimens ◽  
Igf I ◽  
Before And After ◽  
Long Acting

Abstract. The response to GH releasing hormone (GHRH 1–29) and 24-h serum GH and IGF-I levels were measured in 9 insulin-dependent diabetics with retinopathy and 6 normal volunteers before and after different treatment regimens with octreotide, a long-acting somatostatin analogue. Octreotide, 50 μg by sc injection, completely suppressed GHRH-stimulated GH release in both groups. Thrice daily sc injections for up to 20 weeks were associated with variable plasma octreotide levels and failed completely to suppress GH secretion in either the patients or the normal controls. Three days of continuous sc pump infusion (500 μg/24-h) resulted in consistently high plasma octreotide levels and completely suppressed 24-h GH in 4 normal subjects, whilst treatment for up to 16 weeks only partially suppressed GH levels in 6 patients (AUC mU · l−1 · h−1;h 209 ± 81 vs 121 ± 82; P=0.01). Mean ± sd IGF-I levels (μg/l) in the patients (but not controls) were suppressed into the hypopituitary range by median 6 weeks (range 2–16) pump administration (203 ± 62 vs 60 ± 25; P= 0.02). Pump treatment achieved total GH suppression in normal subjects; diabetics with retinopathy seem more resistant to the GH suppressing effects of the drug. However, the reduction of serum IGF-I with prolonged treatment may be of clinical value in arresting the progress of diabetic retinopathy.

Lanreotide Autogel Therapy in Patients with Acromegaly –Current Role and Perspectives for the Future

2010 ◽  
Vol 6 (2) ◽  
pp. 36
Author(s):  
Josef Marek ◽  
Keyword(s):  
Healthcare Professionals ◽  
Single Injection ◽  
Somatostatin Analogues ◽  
Hormonal Control ◽  
Somatostatin Analogue ◽  
Octreotide Lar ◽  
Care Givers ◽  
Active Release ◽  
Long Acting ◽  
Lanreotide Autogel

Lanreotide Autogel is a long-acting (effective for four to six weeks after a single injection) somatostatin analogue that normalises growth hormone (GH) and insulin-like growth factor I levels in about 50% of patients. It causes tumour volumes to shrink by more than 20% in 72–85% of patients. These effects are similar to those with octreotide long active release (LAR). Similarly, there are no differences between octreotide LAR and lanreotide Autogel in improvement of cardiac function, glycometabolic effects or occurrence of side effects, including cholelithiasis. In comparison to octreotide LAR, lanreotide Autogel has the advantage of being available in a convenient pre-filled syringe and it can be injected subcutaneously by patients or their care-givers/partners, omitting the necessity of injections by healthcare professionals. The efficacy of lanreotide can be increased by combination with dopamine agonists. Co-administration of lanreotide Autogel with pegvisomant appears to be safe and to improve hormonal control in a majority of patients with acromegaly partially controlled by somatostatin analogues alone.

Treatment of invasive growth hormone pituitary adenomas with long-acting somatostatin analog SMS 201–995 before transsphenoidal surgery

1994 ◽  
Vol 81 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Tomás Lucas-Morante ◽  
José García-Uría ◽  
Javier Estrada ◽  
Gertrudis Saucedo ◽  
Ana Cabello ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Transsphenoidal Surgery ◽  
Somatostatin Analog ◽  
Clinical Activity ◽  
Tumor Shrinkage ◽  
Content Type ◽  
Gh Secretion ◽  
Igf I ◽  
Long Acting ◽  
Fine Print

✓ The purpose of this study was to determine whether the long-acting somatostatin analog SMS 201–995 (octreotide) shrinks growth hormone (GH)-secreting adenomas and improves the results of subsequent transsphenoidal surgery. Ten previously untreated active acromegalic patients (nine women and one man) with invasive tumors were treated with SMS 201–995 (100 µg subcutaneously every 8 hours) for 6 weeks prior to transsphenoidal surgery. The clinical activity, mean GH secretion, insulin-like growth factor (IGF)-I concentration, and tumor volume were measured under basal conditions and on Days 14, 28, and 42 of treatment. The SMS 201–995 improved the symptoms of acromegaly in all patients. Mean levels of both GH and IGF-I (± standard deviation) were significantly decreased by Day 14 (from 92.9 ± 30.5 to 44.9 ± 20.3 µg/liter and from 10.6 ± 7.4 to 5.9 ± 2.6 U/ml, respectively), after which there were only slight further decreases. Six (60%) of the 10 patients experienced tumor shrinkage ranging from 9% to 78% (mean 30%). When it occurred, tumor shrinkage was significant by Day 14 (7.9 ± 6.3 to 6.5 ± 5.1 cu cm) and no further shrinkage was achieved by longer administration. Transsphenoidal surgery reduced postoperative GH levels to less than 2 µg/liter and IGF-I to less than 1.5 U/ml in six patients (60%). This percentage of cure is higher than expected from the literature and the authors' previous experience. However, an investigation of the influence of this drug on several parameters, such as reduction of tumor size or GH and IGF-I concentrations, has failed to prove any relationship. Only pretreatment size of the tumor was of predictive value with respect to the surgical outcome.

scholarly journals Estradiol Supplementation Enhances Submaximal Feed-Forward Drive of Growth Hormone (GH) Secretion by Recombinant Human GH-Releasing Hormone-1,44-Amide in a Putatively Somatostatin-Withdrawn Milieu

2003 ◽  
Vol 88 (11) ◽  
pp. 5484-5489 ◽  
Author(s):  
Johannes D. Veldhuis ◽  
William S. Evans ◽  
Cyril Y. Bowers
Keyword(s):  
Growth Hormone ◽  
Dose Response ◽  
Crossover Design ◽  
Stimulation Protocol ◽  
Deconvolution Analysis ◽  
Gh Secretion ◽  
Igf I ◽  
Estradiol 17Β ◽  
Dose Response Function ◽  
Stimulation Of

Abstract To test the clinical hypothesis that an estrogen-enriched milieu enhances GHRH action, we administered placebo (Pl) and estradiol-17β (E2) orally for 23 d to six postmenopausal women in a prospectively randomized, double-masked, within-subject crossover design with 6 wk intervening. The GHRH stimulation protocol entailed consecutive iv infusion of l-arginine and a single iv pulse of saline or one of five randomly ordered doses of recombinant human GHRH-1,44-amide (0.03, 0.1, 0.3, 1.0, or 3.0 μg/kg) in a total of 12 separate morning, fasting sessions. GH secretion was monitored by sampling blood every 10 min for 6 h; chemiluminescence assay of GH concentrations; deconvolution analysis of stimulated GH release; and nonlinear dose-response reconstruction. Supplementation with E2, compared with Pl: 1) increased (mean ± sem) E2 concentrations from 18 ± 3 (Pl) to 164 ± 12 pg/ml (to convert to picomoles per liter, multiply by 3.57) (P < 0.001); 2) decreased IGF-I concentrations from 181 ± 14 to 120 ± 11 μg/liter (P < 0.01); 3) elevated mean GH concentrations from 0.27 ± 0.06 to 0.59 ± 0.08 μg/liter (P = 0.014); 4) potentiated GH secretion stimulated by l-arginine alone by 1.43-fold (P = 0.012); 5) reduced the ED50 of GHRH from 0.27 ± 0.02 to 0.13 ± 0.01 μg/kg (P < 0.01), denoting enhanced GHRH potency; and 6) heightened the maximal slope of the dose-response function from 1.1 ± 0.1 to 1.4 ± 0.05 [(μg/liter) (μg/kg)−1] (P < 0.05), signifying augmented pituitary sensitivity. The foregoing facilitative mechanisms were specific because E2 replacement did alter maximal l-arginine/GHRH-induced GH secretion, indicating unchanged secretagogue efficacy. In conclusion, inasmuch as E2 also attenuates inhibition of GH secretion by infused somatostatin and potentiates stimulation of GH secretion by GH-releasing peptide-2, we postulate that estrogenic steroids drive pulsatile GH production in part via mechanisms that include all three of GHRH, somatostatin, and putatively GH-releasing peptide/ghrelin signaling.

scholarly journals Efficacy and Safety of an Octreotide Implant in the Treatment of Patients With Acromegaly

2013 ◽  
Vol 98 (10) ◽  
pp. 4047-4054 ◽  
Author(s):  
Carla Chieffo ◽  
David Cook ◽  
Qinfang Xiang ◽  
Lawrence A. Frohman
Keyword(s):  
Confidence Interval ◽  
International Study ◽  
Blood Levels ◽  
Open Label ◽  
Phase 3 ◽  
Pivotal Phase ◽  
Octreotide Lar ◽  
Gh Secretion ◽  
Igf I ◽  
Long Acting

Abstract Context: Acromegaly is caused by excessive GH secretion and IGF-I overproduction. The goals of treatment are to reduce GH and IGF-I values to normal and relieve the associated symptoms. Objective: The purpose of this article was to demonstrate that an octreotide implant (84 mg) is safe and efficacious in patients with acromegaly who were responsive to prior monthly octreotide long-acting release (LAR) injections. Design: This was a phase 3, open-label study. Before treatment, subjects received a stable monthly dose of octreotide LAR injections (10−40 mg) for ≥3 months. Randomization was in a 3:1 ratio to either a 6-month octreotide implant or monthly octreotide LAR injections. Setting: This was a multicenter, international study conducted in private or institutional practices. Subjects: Enrollment included 163 subjects (aged ≥18 years) with acromegaly. Main Outcome Measure: The efficacy, safety, and tolerability of the octreotide implant during 24 weeks of treatment was evaluated. Results: After 24 weeks, the success rate of the implant for maintenance of IGF-I and GH levels was 86% (95% confidence interval, 80.3%) compared with a rate of 84% (95% confidence interval, 73.8%) for octreotide LAR. Serum octreotide concentrations after implant insertion increased within 8 days and peaked between days 14 and 28. The overall safety of the octreotide implant and octreotide LAR were similar. Diarrhea and headache were more frequent with the implant, whereas cholecystitis and hypertension were more frequent with octreotide LAR. Conclusions: In this pivotal phase 3 study, the octreotide implant maintained reduced blood levels of GH and IGF-I with continuous octreotide release over 6 months, which was well tolerated.

scholarly journals Efficacy and tolerability of lanreotide Autogel therapy in acromegalic patients previously treated with octreotide LAR

2004 ◽  
pp. 317-324 ◽  
Author(s):  
O Alexopoulou ◽  
P Abrams ◽  
J Verhelst ◽  
K Poppe ◽  
B Velkeniers ◽  
...  
Keyword(s):  
Side Effects ◽  
Fixed Dose ◽  
Normal Range ◽  
Open Label ◽  
Technical Problems ◽  
Octreotide Lar ◽  
Igf I ◽  
Long Acting ◽  
Local Side ◽  
Lanreotide Autogel

OBJECTIVE: This open label, multicentre study was designed to evaluate the efficacy and tolerability of lanreotide Autogel (L-Autogel) in acromegalic patients over a 24-week period. The outcome of treatment with this new, long-acting, aqueous formulation of lanreotide was also compared with the patients' previous treatment with octreotide long acting repeatable (LAR). DESIGN AND METHODS: Twenty-five acromegalic patients (13 males, mean age 51+/-12 years) were switched from octreotide LAR (20-40 mg/4 weeks for at least 6 months) to L-Autogel, given deep subcutaneously at a fixed dose of 90 mg/4 weeks. After 12 weeks, the dose of L-Autogel was titrated according to patients' mean GH and IGF-I levels at week 8. It was increased to 120 mg/4 weeks if GH>2.5 microg/l or if IGF-I was above the age-adjusted normal range. It was reduced to 60 mg/4 weeks if mean GH<1 microg/l and IGF-I was within the normal range. If the values did not fall within these ranges, the dose remained unchanged at 90 mg. RESULTS: After 24 weeks of treatment with L-Autogel (final doses 60 mg in 3 patients, 90 mg in 4 patients and 120 mg in 18 patients), mean serum GH (2.9+/-2.4 microg/l) and IGF-I concentrations (332+/-193 microg/l) remained statistically unchanged when compared with baseline values under octreotide LAR (GH 2.4+/-1.8 microg/l and IGF-I 337+/-201 microg/l, non significant (NS)). There was a significant improvement of the acromegalic symptom score over the study period, from 4.8+/-3.4 to 2.8+/-2.5 (P<0.001) and a small but significant reduction in the residual pituitary tumour volume (P<0.05). Local side-effects were observed less frequently and no technical problems were encountered with the L-Autogel injections, as opposed to treatment with octreotide LAR (60 difficult injections/150 (P<0.001)). CONCLUSIONS: L-Autogel appears to be as effective as octreotide LAR in lowering GH and IGF-I concentrations in acromegalic patients. This treatment was also well tolerated by the patients, giving fewer local side-effects and technical problems with injections. These advantages may improve the long-term acceptability of medical treatment in acromegaly.

scholarly journals Differential Diagnosis of the Short IGF-I-Deficient Child with Apparently Normal Growth Hormone Secretion

2021 ◽  
pp. 1-24
Author(s):  
Jan M. Wit ◽  
Sjoerd D. Joustra ◽  
Monique Losekoot ◽  
Hermine A. van Duyvenvoorde ◽  
Christiaan de Bruin
Keyword(s):  
Growth Hormone ◽  
Differential Diagnosis ◽  
Growth Hormone Secretion ◽  
Normal Growth ◽  
Stimulation Test ◽  
Healthy Children ◽  
Genetic Causes ◽  
Gh Secretion ◽  
Igf I

The current differential diagnosis for a short child with low insulin-like growth factor I (IGF-I) and a normal growth hormone (GH) peak in a GH stimulation test (GHST), after exclusion of acquired causes, includes the following disorders: (1) a decreased spontaneous GH secretion in contrast to a normal stimulated GH peak (“GH neurosecretory dysfunction,” GHND) and (2) genetic conditions with a normal GH sensitivity (e.g., pathogenic variants of <i>GH1</i> or <i>GHSR</i>) and (3) GH insensitivity (GHI). We present a critical appraisal of the concept of GHND and the role of 12- or 24-h GH profiles in the selection of children for GH treatment. The mean 24-h GH concentration in healthy children overlaps with that in those with GH deficiency, indicating that the previously proposed cutoff limit (3.0–3.2 μg/L) is too high. The main advantage of performing a GH profile is that it prevents about 20% of false-positive test results of the GHST, while it also detects a low spontaneous GH secretion in children who would be considered GH sufficient based on a stimulation test. However, due to a considerable burden for patients and the health budget, GH profiles are only used in few centres. Regarding genetic causes, there is good evidence of the existence of Kowarski syndrome (due to <i>GH1</i> variants) but less on the role of <i>GHSR</i> variants. Several genetic causes of (partial) GHI are known (<i>GHR</i>, <i>STAT5B</i>, <i>STAT3</i>, <i>IGF1</i>, <i>IGFALS</i> defects, and Noonan and 3M syndromes), some responding positively to GH therapy. In the final section, we speculate on hypothetical causes.

scholarly journals Somatostatin receptors subtypes 2 and 5, dopamine receptor type 2 expression and gsp status as predictors of octreotide LAR® responsiveness in acromegaly

2008 ◽  
Vol 52 (8) ◽  
pp. 1288-1295 ◽  
Author(s):  
Leonardo Vieira Neto ◽  
Giselle Fernandes Taboada ◽  
Mônica Roberto Gadelha
Keyword(s):  
Growth Hormone ◽  
Quantitative Analysis ◽  
Dopamine Receptor ◽  
Molecular Analysis ◽  
Somatostatin Receptor ◽  
Somatostatin Receptors ◽  
Laboratory Data ◽  
Octreotide Lar ◽  
Acute Test ◽  
Igf I

We present two acromegalic patients in which clinical and molecular data are discussed in regard to their ability to predict long term octreotide LAR® therapy response. Case reports: Patient 1: female, 36 years old at diagnosis. Basal GH and IGF-I at diagnosis were 133 ng/mL and 181% above the upper limit of reference values (ULRV), respectively. Growth hormone during acute test with subcutaneous octreotide decreased from 133 to 13 ng/mL. Patient started on primary octreotide LAR® therapy (20mg q28 days) and achieved biochemical parameters of disease control after 6 months. Molecular analysis of tumor fragments: gsp +; quantitative analysis of SSTR (somatostatin receptor) and DR (dopamine receptor) mRNA - SSTR2 23954; SSTR5 2407; DR2 total 17016 copies. Patient 2: male, 38 years old at diagnosis. Basal GH and IGF-I at diagnosis were 120 ng/mL and 114% ULRV, respectively. Patient underwent non-curative trans-sphenoidal surgery. Post-operative GH and IGF-I were 112 ng/mL and 137% ULRV, respectively. Growth hormone during acute test with subcutaneous octreotide decreased from 112 to 7 ng/mL. Octreotide LAR® therapy (20 mg q28 days) was then initiated. After 6 months of treatment, patient did not attain biochemical control of disease and displayed increased tumor volume. Molecular analysis of tumor fragments: gsp not done; quantitative analysis of SSTR and DR mRNA - SSTR2 416; SSTR5 3767; DR2 total 3439 copies. In conclusion, these two cases illustrate how laboratory data can be conflicting as predictors of octreotide LAR® responsiveness and how molecular analysis of tumor fragments can help explain different behaviors in clinically similar patients.

Growth hormone binding protein and growth hormone availability in acromegalic patients treated with long-acting octreotide (Sandostatin-LAR)

1997 ◽  
Vol 136 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Sanne Fisker ◽  
Andreas Kaal ◽  
Marcella Montini ◽  
Alberto Pedroncelli ◽  
Giorgio Pagani ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Binding Protein ◽  
Hormone Binding ◽  
Age And Gender ◽  
Growth Hormone Binding Protein ◽  
Igf I ◽  
Octreotide Treatment ◽  
Hormone Binding Protein ◽  
And Gender ◽  
Long Acting

Abstract Objective: In the medical treatment of acromegaly different factors are influencial; among these the impact on growth hormone binding protein (GHBP) has not been clarified. Design: Twenty acromegalic patients and nineteen age- and gender-matched normal subjects participated in this study. The patients were treated for 21 months with depot long-acting microsphere-enclosed octreotide (Sandostatin-LAR). Previously, all the patients were treated s.c. with octreotide t.i.d. After a 2-week wash-out period (baseline) the patients received the first i.m. injection of the long-acting octreotide. The first two injections were administered at 60-day intervals; thereafter the injections were at 28-day intervals. Methods: The levels of GHBP, complexed GHBP, growth hormone (GH) and insulin-like growth factor-I (IGF-I) were determined in fasting serum samples. Results: In the 2-week wash-out period GHBP levels decreased from 1·13 ± 0·17 to 0·92 ± 0·15 nmol/l (P < 0·05). During the 21-months treatment, GHBP increased again to 1·10 ± 0·16 nmol/l. In the age- and gender-matched control group GHBP levels were significantly higher at all times (1·95 ± 0·21 nmol/l, P(all) < 0·02). Mean levels of 8-h GH decreased from 12·6 ± 2·58 μg/l at baseline to 1·97 ± 0·20 μg/l after 21 months of treatment (P < 0·05). Mean 8-h GH levels were unchanged during long-acting octreotide treatment compared with levels during s.c. treatment (1·97 ± 0·20 μg/l and 1·90 ± 0·20 μg/l respectively). In fasting blood samples GH-complexed GHBP ranged from 13·8 ± 2·4% (9 months) to 25·4 ± 4·5% (baseline) of total GHBP. Serum IGF-I increased from 367 ± 45 to 764 ± 80 μg/l (P < 0·05) during the 2-week wash-out period and decreased to 290 ± 35 μg/l (P < 0·05) after 21 months of treatment with long-acting octreotide. IGF-I levels after 21 months were significantly lower than during s.c. octreotide treatment (P < 0·05). Conclusion: Serum GHBP levels are similar during treatment with long-acting octreotide as compared with regular octreotide. Furthermore, significant changes in GHBP can occur within 2 weeks. Finally, in addition to the lowering effect on GH levels, the induced increase in GHBP levels may imply a further advantage in octreotide treatment of acromegaly, circulating GH bound to GHBP may less readily reach the tissues. European Journal of Endocrinology 136 61–66

scholarly journals Pegvisomant therapy in pituitary gigantism: successful treatment in a 12-year-old girl

2005 ◽  
Vol 153 (2) ◽  
pp. 195-201 ◽  
Author(s):  
M Rix ◽  
P Laurberg ◽  
A S Hoejberg ◽  
B Brock-Jacobsen
Keyword(s):  
Well Being ◽  
Lymphocytic Infiltration ◽  
High Serum ◽  
Serum Prolactin ◽  
Great Promise ◽  
Oral Glucose ◽  
Somatostatin Analogue ◽  
Tall Stature ◽  
Gh Secretion ◽  
Igf I

Objective: The use of a growth hormone (GH) receptor antagonist, pegvisomant has shown great promise in adults with acromegaly, but experience in paediatric patients is lacking. We aimed to describe the results of pegvisomant therapy in a 12-year-old girl with an aggressive GH-secreting pituitary tumour. Design: To evaluate the ability of pegvisomant therapy to control the effects of peripheral GH excess in a case of pituitary gigantism. Methods: Pegvisomant was introduced at 10 mg/day, given subcutaneously, and gradually increased to 20 mg/day until serum IGF-I was normal for age. Results: A large pituitary adenoma with suprasellar extension was diagnosed in a 12-year-old girl with progressive tall stature (178 cm), GH hypersecretion without suppression during oral glucose loading (nadir serum GH, 90 mU/l), high serum IGF-I and serum prolactin levels. Surgical extirpation was not possible because tumour tissue was fibrous and adherent to the optical nerves. Histological examination showed a mixed GH- and prolactin-secreting adenoma with lymphocytic infiltration of B and T cells. Treatment with a dopamine agonist, cabergoline, normalized serum prolactin, but GH secretion was resistant to both somatostatin analogue, octreotide and cabergoline. Radiation followed by pegvisomant therapy titrated up in dose to 20 mg/day led to a marked reduction in GH secretion and normalization of IGF-I, and to growth arrest and improvement of well-being. Conclusions: We suggest that treatment in pituitary gigantism with pegvisomant is safe and may normalize IGF-I levels and effectively stop growing.

Sign in / Sign up

Export Citation Format

Share Document