Treatment of acromegaly with the growth hormone-receptor antagonist pegvisomant

Article Abstract:

The drug pegvisomant appears to be effective in treating acromegaly. Acromegaly is a pituitary disorder that causes excess amounts of growth hormone and insulin-like growth factor I (IGF-I). Pegvisomant blocks the receptor for growth hormone. Researchers randomly assigned 112 people with acromegaly to take one of three different doses of pegvisomant or a placebo, or inactive substance. About 90% of the patients taking the highest dose achieved normal blood levels of growth hormone and IGF-I, compared to only 10% of those taking the lowest dose. Dosages ranged from 10 milligrams to 20 milligrams per day.

Drug therapy, Acromegaly

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Growth hormone for the elderly?

Article Abstract:

The production of insulin-like growth hormone I (IGF-I, or somatomedin C) in the liver and elsewhere is stimulated by growth hormone, and IGF-I is responsible for this substance's diverse effects. Concentrations of IGF-I decrease with age in many people, although even in the eighth and ninth decades of life, 45 percent have IGF-I levels equivalent to those of people in their twenties. IGF-I levels are inversely correlated with fatness. Since decreases in muscle mass and increases in fat also occur with age, researchers attempted to determine whether growth hormone could be beneficial in the elderly. An experiment in the July 5, 1990, issue of The New England Journal of Medicine describes such effects after men between the ages of 61 and 81 received synthetic human growth hormone for six months. Blood levels of IGF-I increased, and the men had increases in lean body mass, and decreases in the amount of fat tissue. Other reports with similar findings are cited. However, such studies should be considered preliminary at this point, since growth hormone can have adverse effects on several systems in the body. For instance, short-term administration alters fundamental metabolic processes, including insulin secretion, glucose uptake, and changes in blood cholesterol levels. The effects of growth hormone on muscle function have not been evaluated fully, in spite of claims that it improves athletic performance. Nor is it clear when delivery of growth hormone to aging adults should begin, for maximal beneficial effects. Dosage and dose schedule need to be worked out. Ethical objections to a growth-hormone program among aging adults include the possibility it would be given to people with no deficit in growth hormone. The product is costly; at the doses used in the experiment, it would run $13,800 per year. Given these objections, a better target for growth hormone than the elderly would be patients with severe catabolic illnesses (associated with high rates of metabolic destruction). The current studies thus serve as a beginning step in understanding the actions of this hormone on adults. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aging, Measurement, Prevention, Physiological aspects, Body weight, Insulin-like growth factor 1, Insulin-like growth factor I, editorial

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Growth hormone therapy in adults and children

Article Abstract:

Growth hormone therapy is very effective as a replacement treatment for children and adults with a growth hormone deficiency. Many researchers have also tested growth hormone therapy in burn victims, AIDS patients, and severely ill patients. However, even though the hormone decreases fat mass and increases muscle mass, it has not improved survival rates in these patients. Growth hormone therapy for adults has only been prescribed since the late 1980s, so there is no evidence of its long-term usefulness or safety.

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