pasireotidi

Pasireotide is a synthetic somatostatin analogue used in the management of certain pituitary and neuroendocrine disorders. It binds with high affinity to multiple somatostatin receptors, particularly SSTR5, and inhibits the excessive secretion of hormones from pituitary adenomas and other neuroendocrine tissues. By suppressing excess growth hormone and insulin-like growth factor 1, pasireotide can help control acromegaly; by reducing adrenocorticotropic hormone secretion, it can lower cortisol levels in some patients with Cushing’s disease.

In adults, pasireotide is approved for specific indications related to acromegaly and Cushing’s disease. For acromegaly, it is used in patients who are not adequately controlled with or cannot tolerate first-line therapies, and it can be employed when tumor growth needs to be addressed. For Cushing’s disease, it is considered in adults with persistent disease or in whom pituitary surgery is not feasible or has not achieved control. Off-label and investigational uses exist, but regulatory approvals vary by country.

The medication is available in two main formulations: a subcutaneous injection given two times daily and a long-acting release (LAR) formulation administered by intramuscular injection every four weeks. Dosing is individualized and may be adjusted based on biochemical response (GH, IGF-1, or cortisol levels) and patient tolerability.

Common adverse effects include hyperglycemia or new-onset diabetes, gastrointestinal symptoms such as diarrhea and nausea, gallbladder problems including cholelithiasis, fatigue, and injection-site reactions. Because of the risk of glucose intolerance, patients require monitoring of blood glucose and potential adjustment of antidiabetic therapy. Routine monitoring for gallbladder disease and other adverse effects is typically advised during treatment.