佩格维展（Pegvisomant）是首个临床可用的生长激素受体拮抗剂，对于医治罕见的肢端肥大症（acromegaly）是一个有效的治疗选择。通过超过20年的临床应用经验，其安全性与疗效已得到充分确认。然而，其临床应用的几个方面仍存在争议。佩格维展的高造价限制了其在一些国家的使用，并且最近的研究报告中报道了低于初始临床试验的疗效。在治疗中，肿瘤体积的增加报道因研究不同而存在差异，可能是实际生长或在结束生长抑素受体配体治疗后的再扩张所致。此外，已提出不同的佩格维展与其他治疗药物的组合，旨在降低肢端肥大症的疾病活动并提高或保持疗效，在降低副作用和成本的同时。本综述旨在评估当前关于佩格维展的安全性和疗效的临床数据，同时解决其使用中的争议问题。版权所有©2023。Elsevier Inc.出版。

Pegvisomant, the first and currently only clinically available growth hormone receptor antagonist, is an effective therapeutic option for the medical treatment of acromegaly, a rare disorder characterized by excessive growth hormone secretion. With now over 20 years of real world experience, its safety and efficacy is well-established. However, several aspects of its clinical use are still controversially discussed. The high cost of pegvisomant has limited its use in several countries, and recent studies have reported a lower efficacy than the initial clinical trials. A reported increase in tumor volume under therapy varies between studies and has been attributed to either actual growth or re-expansion after cessation of somatostatin receptor ligand therapy. Furthermore, different combinations of pegvisomant and other therapeutic agents aiming at reduction of acromegaly disease activity have been proposed to increase or retain effectiveness while lowering side effects and cost. This review aims to assess current clinical data on the safety and efficacy of pegvisomant while also addressing controversies surrounding its use.Copyright © 2023. Published by Elsevier Inc.