A 45-year-old lady presents with complaints of a progressive increase in the size of hands and feet and shoe size for past 5 years. The family members have noticed a change in her facial appearance in the form of coarsening of features and her voice has become sonorous. She also has complaints of frequent headaches for past 1 year. She complains of amenorrhea for past 5 years. She also has complaints of joint pains for past 3 years which have become more severe for the past 3 months. She is hypertensive for past 1 year and complaints of grade 2 dyspnea on exertion and her hypertension is controlled on 10 mg of cilnidipine and 40 mg of telmisartan. She is not a known diabetic and has checked her random sugars 1 week back which was normal. She is not on any other medications presently (Fig. 1.1).
What is the status of GH receptor antagonist treatment?
Pegvisomant is a GH receptor antagonist that competes with endogenous GH for its receptor and prevents functional dimerization and signal transduction by the GH receptor. It is highly effective in reducing growth hormone levels in patients who are resistant to other forms of therapy. Pegvisomant is highly effective in normalizing IGF-I values (>90%), including patients who are partially or completely resistant to other medical therapies.
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