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Peptide

Pegvisomant (Somavert)

Pegvisomant is a genetically modified growth hormone analog that functions as a GH receptor antagonist. FDA-approved in 2003, it is the first and only GH receptor antagonist for acromegaly. It is indicated for patients with inadequate response to surgery, radiation, or somatostatin analogs. Phase III trials showed up to 97% of patients achieving IGF-1 normalization with long-term treatment, making it the most effective medical therapy for biochemical control.

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Best evidence
Grade A
Conditions studied
1
Outcomes
10
Graded outcomes
5113

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

1 condition, plus general outcomes

Acromegaly

Acromegaly: outcomes studied for Pegvisomant (Somavert)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Treatment-Resistant Acromegaly

100% IGF-1 normalization in octreotide-resistant patients. Effective after failed surgery and somatostatin analog therapy.

Improves (the measure goes down)Large effect19 studies

Studies that measured treatment-resistant acromegaly

and 9 more in the citations list

Acromegaly Symptoms

Improvement in soft tissue swelling, fatigue, perspiration, and joint symptoms associated with GH/IGF-1 excess.

Improves (the measure goes down)Moderate effect19 studies

Studies that measured acromegaly symptoms

and 9 more in the citations list

IGF-1 Normalization

97% achieved normal IGF-1 at 12 months in clinical trials. Phase III: 89% normalization with 20mg daily dose. Most effective medical therapy for biochemical control.

Changes; see studiesLarge effect14 studies

Studies that measured igf-1 normalization

and 4 more in the citations list

Serum IGF-1 Levels

Dose-dependent reduction: 62.5% decrease with 20mg/day vs 4% with placebo. German Observational Study showed sustained reduction from 1.75x to 0.89x ULN over 24 months.

Improves (the measure goes down)Large effect14 studies

Studies that measured serum igf-1 levels

and 4 more in the citations list

Glucose Metabolism

Significant decrease in serum insulin and glucose concentrations (P<0.05). Particularly beneficial in acromegaly patients with coexistent diabetes mellitus.

Improves (the measure goes down)Moderate effect14 studies

Studies that measured glucose metabolism

and 4 more in the citations list

General

General: outcomes studied for Pegvisomant (Somavert)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Hormone Levels

12 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Moderate effect11 studies

Studies that measured hormone levels

and 1 more in the citations list

Anti-Cancer Activity

3 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect4 studies

Studies that measured anti-cancer activity

Blood Glucose Control

2 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes down)Small effect3 studies

Studies that measured blood glucose control

Safety/Tolerability

2 systematic reviews and preclinical studies support this finding. Evidence includes systematic reviews/meta-analyses. Primarily preclinical evidence.

Improves (the measure goes up)Small effect3 studies

Studies that measured safety/tolerability

Liver Protection

2 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect3 studies

Studies that measured liver protection

Key findings

  • Treatment-Resistant AcromegalyAcromegalyImproves (the measure goes down)
  • Acromegaly SymptomsAcromegalyImproves (the measure goes down)
  • IGF-1 NormalizationAcromegalyChanges; see studies

Studies cited

35 studies from PubMed

  1. Personalized medicine in acromegaly: insights from the ACROFAST clinical trial.Expert review of endocrinology & metabolism, 2025 · PMID 41020777
  2. Medical treatment in acromegaly: a network meta-analysis.European journal of endocrinology, 2025 · PMID 41140134
  3. Pegvisomant in managing comorbidities of acromegaly: a review.Reviews in endocrine & metabolic disorders, 2025 · PMID 41160328
  4. Efficacy and Safety of Pegvisomant in the Treatment of Acromegaly.Archives of medical research, 2023 · PMID 37659952
  5. Blockade of growth hormone receptor signaling by using pegvisomant: A functional therapeutic strategy in hepatocellular carcinoma.Frontiers in oncology, 2022 · PMID 36276070
  6. Preconception use of pegvisomant alone or as combination therapy for acromegaly: a case series and review of the literature.Pituitary, 2020 · PMID 32451986
  7. Combined therapy of somatostatin analogues with pegvisomant for the treatment of acromegaly: a meta-analysis of prospective studies.BMC endocrine disorders, 2020 · PMID 32811475
  8. Pegvisomant Improves Glucose Metabolism in Acromegaly: A Meta-Analysis of Prospective Interventional Studies.The Journal of clinical endocrinology and metabolism, 2019 · PMID 30869797
  9. Effectiveness and safety of pegvisomant: a systematic review and meta-analysis of observational longitudinal studies.Endocrine, 2019 · PMID 30145746
  10. The Effect of the Exon-3-Deleted Growth Hormone Receptor on Pegvisomant-Treated Acromegaly: A Systematic Review and Meta-Analysis.Neuroendocrinology, 2017 · PMID 27513761
  11. Pegvisomant: a growth hormone receptor antagonist used in the treatment of acromegaly.Pituitary, 2017 · PMID 27631335
  12. Pegvisomant-primed growth hormone (GH) stimulation test is useful in identifying true GH deficient children.Hormones (Athens, Greece), 2017 · PMID 29278515
  13. Diabetes in Patients With Acromegaly.Current diabetes reports, 2017 · PMID 28150161
  14. Circulating levels of pegvisomant and endogenous growth hormone during prolonged pegvisomant therapy in patients with acromegaly.Clinical endocrinology, 2014 · PMID 23650996
  15. Extra-hepatic Acromegaly.European endocrinology, 2013 · PMID 30349613
  16. Long-term safety and efficacy of pegvisomant in combination with long-acting somatostatin analogues in acromegalyJ Clin Endocrinol Metab, 2012 · PMID 22180962
  17. Pegvisomant for acromegalyDrugs, 2011 · PMID 21846727
  18. Lipodystrophy during pegvisomant therapy: a case report and review of the literature.Clinics (Sao Paulo, Brazil), 2010 · PMID 21049223
  19. Safety and efficacy of pegvisomant in acromegaly: a reviewPituitary, 2009 · PMID 19628580
  20. Treatment of acromegaly with the GH receptor antagonist pegvisomant in clinical practice: safety and efficacy evaluation from the German Pegvisomant Observational StudyEur J Endocrinol, 2007 · PMID 17218728
  21. Pegvisomant--growth hormone receptor antagonist in the treatment of acromegalyNeuro Endocrinol Lett, 2007 · PMID 18058736
  22. Discovery and uses of pegvisomant: a growth hormone antagonist.Endokrynologia Polska, 2007 · PMID 18058724
  23. ACROSTUDY: a retrospective, cross-sectional study of pegvisomant use for acromegalyEur J Endocrinol, 2006 · PMID 16467203
  24. The growth hormone receptor antagonist pegvisomant blocks both mammary gland development and MCF-7 breast cancer xenograft growth.Breast cancer research and treatment, 2006 · PMID 16541323
  25. Growth hormone receptor antagonists.Neuroendocrinology, 2006 · PMID 17047392
  26. Treatment of pituitary tumors: pegvisomant.Endocrine, 2005 · PMID 16311417
  27. The effects of pegvisomant on glucose metabolism in acromegalyJ Clin Endocrinol Metab, 2004 · PMID 15131058
  28. [Growth hormone-receptor antagonist pegvisomant].Deutsche medizinische Wochenschrift (1946), 2004 · PMID 15497105
  29. Pegvisomant: an advance in clinical efficacy in acromegalyEur J Endocrinol, 2003 · PMID 12670298
  30. Growth hormone receptor antagonists.Minerva endocrinologica, 2002 · PMID 12511851
  31. Long-term treatment of acromegaly with pegvisomant, a growth hormone receptor antagonistLancet, 2001 · PMID 11734231
  32. Successful treatment of resistant acromegaly with a growth hormone receptor antagonistEur J Endocrinol, 2001 · PMID 11581004
  33. Clinical use of a growth hormone receptor antagonist in the treatment of acromegalyTrends Endocrinol Metab, 2001 · PMID 11595543
  34. Treatment of acromegaly with the growth hormone-receptor antagonist pegvisomantN Engl J Med, 2000 · PMID 10770982
  35. Pegvisomant: a growth hormone receptor antagonist for the treatment of acromegaly.Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society, 2000 · PMID 10984267