Pegvisomant Disease Interactions

Pegvisomant is an analog of human growth hormone (GH) that selectively binds to growth hormone (GH) receptors on cell surfaces, where it blocks the binding of endogenous GH, and thus interferes with GH signal transduction. The use of growth hormones opposes the effects of insulin on carbohydrate metabolism by decreasing insulin sensitivity; therefore, glucose intolerance may improve in some patients treated with pegvisomant. Diabetic patients should be monitored closely, and the doses of anti-diabetic drugs may be reduced as necessary to avoid hypoglycemia. Blood glucose levels should be evaluated as appropriate.

Asymptomatic, transient elevations in transaminases up to 15 times ULN have been observed in patients treated with pegvisomant. Baseline serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum total bilirubin (TBIL), and alkaline phosphatase (ALP) levels should be obtained prior to initiating therapy with pegvisomant. Care should be exercised when using this agent in patients with liver dysfunction and its use should be used in accordance with the information presented in the manufacturer prescribing information with respect to liver test abnormalities.