Signifor LAR (pasireotide long acting release) / Recordati - LARVOL DELTA

Pasireotide-LAR and pegvisomant combination in resistant acromegaly: a case series of predominantly mammosomatotroph adenomas. (PubMed, Pituitary) - "In this series of predominantly mammosomatotroph adenomas in younger adults, combination PAS plus PEGV offers potential durable biochemical control, tumor stability and PEGV dose reduction in treatment-resistant acromegaly. Glucose monitoring during treatment is essential as concomitant use of PEGV does not appear to mitigate PAS-induced glycemic deterioration. Larger prospective studies are needed to better define predictors of response."

Journal • Retrospective data • Acromegaly • Cardiovascular • Endocrine Disorders • Hepatology • Metabolic Disorders • Oncology • Pain • IGF1

Cost-effectiveness of pasireotide as second-line therapy for adult acromegaly patients from the perspective of the Brazilian Unified Health System. (PubMed, Front Endocrinol (Lausanne)) - "Resistance to first-line medical treatment necessitates effective second-line therapies, including pasireotide long-acting release (PAS LAR) and pegvisomant (PEG). Compared to FGSRLs, PAS LAR provided better outcomes with higher costs. With limited options for second-line medical treatment in Brazil, the reimbursement of PAS LAR in acromegaly can be considered a cost-effective strategy for acromegaly patients."

HEOR • Journal • Acromegaly • Endocrine Disorders • Pituitary Gland Carcinoma

Beyond biochemical control: headache resolution with pasireotide in a patient with acromegaly and residual tumor. (PubMed, JCEM Case Rep) - "Despite transsphenoidal surgery, radiotherapy, and sequential medical therapy with octreotide, cabergoline, and pegvisomant over 3 years, insulin-like growth factor 1 (IGF-1) levels remained elevated and headache burden persisted. Initiation of pasireotide long-acting release was followed by rapid normalization of IGF-1 levels and complete resolution of headache, with improvement in other acromegaly related symptoms. This case supports the potential role of pasireotide in selected patients with biochemically and clinically treatment-resistant acromegaly and contributes to the growing real-world evidence regarding its use in patients with residual disease in surgically challenging locations."

Journal • Acromegaly • Endocrine Disorders • Oncology • Pain • Pituitary Gland Carcinoma • IGF1

Combination Therapy with Pasireotide LAR and Pegvisomant in Treatment-Resistant Acromegaly: A Case Series (ENDO 2026) - " 5 pts, 4 F, 1M (age 15-44), with somatotroph (1) or mammosomatotroph (4) adenomas, 3 uncontrolled on PAS-LAR, 1 uncontrolled on octreotide LAR+PEGV, and 1 uncontrolled on maximum octreotide LAR, demonstrated significant biochemical improvement on PAS-LAR (40 or 60 mg every 28 days)+ PEGV treated over a median of 3.0 years, range 2.2-5.2 years. Combination PAS-LAR and PEGV is a viable long-term option for treatment-resistant acromegaly, offering meaningful biochemical improvement, maintenance of tumor stability, and potential PEGV dose reduction. Side effects do not seem to be potentiated by combination therapy, but PEGV did not prevent PAS-related hyperglycemia in our pts. Severe acromegaly may (at least temporarily) respond to higher doses of PAS-LAR + PEGV while awaiting repeat surgery and/or radiation."

Clinical • Combination therapy • Acromegaly • Cardiovascular • Diabetes • Endocrine Disorders • Gastroenterology • Metabolic Disorders • IGF1 • SSTR • SSTR2

Glycemic and Lipidic Profiles of Patients with Acromegaly Long-Term Treated with Pasireotide LAR after Dose Downtitration (ENDO 2026) - "Furthermore, we showed for the first time that lipid metabolism also improves with dose downtitration. In selected patients on long-term PAS-LAR therapy with good biochemical disease control, but metabolic deterioration, cautious dose reduction initially should be considered, rather than direct discontinuation of the drug."

Clinical • Acromegaly • Endocrine Disorders • Metabolic Disorders • IGF1

Pasireotide- Augmented Therapy with Diazoxide for Refractory Post Bariatric Surgery Hypoglycemia: Longitudinal Case Reports (ECO 2026) - "Management includes dietary changes and pharmacotherapy including Acarbose and Diazoxide. The cases demonstrate dose-dependent glycemic response to Pasireotide in PBH. Response to long-acting Pasireotide may be less evident at smaller doses. Pasireotide use is limited by potential hyperglycemia."

Bariatric surgery • Case report • Clinical • Surgery • Gastric Cancer • Hypoglycemia • Immunology • Pancreatic Cancer • Solid Tumor • IGF1

Current Treatment Landscape of Acromegaly. (PubMed, J Clin Endocrinol Metab) - "Pasireotide long-acting release, a somatostatin receptor multiligand, achieves more favorable biochemical control rates but is associated with an increased risk of hyperglycemia. Pegvisomant, a GH receptor antagonist, can be used as monotherapy or in combination with SRLs. The spectrum of medical therapy has expanded with the advent of oral octreotide capsules; the oral selective somatostatin receptor subtype 2 agonist, paltusotine; and monthly self-administered subcutaneous octreotide. This review outlines the updates to current acromegaly treatment options and their impact on patient outcomes."

Journal • Acromegaly • Diabetes • Endocrine Disorders • SSTR

Developments in Pharmacotherapy for Acromegaly: Current and Emerging Approaches. (PubMed, Drugs) - "Medical therapies in current use for acromegaly are somatostatin receptor ligands (SRLs) (octreotide long-acting release [LAR], octreotide acetate, lanreotide depot, octreotide subcutaneous (SC) depot, pasireotide LAR, oral octreotide, paltusotine), dopamine agonists (cabergoline) and growth hormone receptor antagonists (pegvisomant)...Several investigational drugs are in development towards addressing unmet needs of patients with acromegaly, including new formulations of SRLs (lanreotide prolonged-release formulation, Debio 4126, pasireotide SC depot), novel SRLs (somatoprim, HTL0030310), monoclonal antibodies against growth hormone, and new growth hormone receptor antagonists. Current and emerging therapies are offering renewed hope for disease control. More studies including comparator agents, identification of accurate biomarkers and models predictive of clinical effectiveness may further improve the care of patients with acromegaly."

Journal • Review • Acromegaly • Endocrine Disorders • SSTR

Case Report: Paradoxical responses to pasireotide in a patient with a silent corticotroph adenoma that transformed into an ACTH-secreting adenoma. (PubMed, Front Oncol) - "Pasireotide LAR successfully reduced the tumor mass despite paradoxical responses. A transient increase in hypercortisolemia after pasireotide LAR was difficult to predict but was managed with steroidogenesis inhibitors."

Journal • Cushing’s Disease • Endocrine Disorders • Oncology

Efficacy and Safety of Pharmacologic Therapies in Acromegaly: A Systematic Literature Review and Network Meta-Analysis. (PubMed, J Clin Endocrinol Metab) - "This systematic review and NMA consolidate recent high-quality RCT evidence for acromegaly treatments. Paltusotine emerges as a promising alternative to injectable SRLs, with favorable efficacy, safety, and AE-related discontinuation patterns. These findings may inform clinical decision-making and guideline development, if confirmed by clinical experience."

Journal • Retrospective data • Acromegaly • Endocrine Disorders • SSTR

Cost-effectiveness of pasireotide long-acting release in acromegaly: a systematic literature review and methodology assessment. (PubMed, J Med Econ) - "Evidence on pasireotide LAR's cost-effectiveness versus pegvisomant regimens remains inconclusive. Although two studies indicated that pegvisomant is more cost-effective, the study with the highest methodological credibility found that pasireotide LAR is a cost-effective alternative."

HEOR • Journal • Review • Acromegaly • Endocrine Disorders • SSTR

Indirect Treatment Comparison of Biochemical Control Between Pasireotide Long-Acting Release and Pegvisomant as Second-Line Therapies for Acromegaly, Based on Real-World Evidence (ISPOR-EU 2025) - "This meta-analysis of RWE suggests similar efficacy in normalizing IGF-1 levels between PAS LAR and PEG in the second-line treatment of acromegaly. Further ITCs are planned to assess other comparative outcomes in real-world clinical practice, including tumour response, quality of life, treatment safety and discontinuation."

Clinical • HEOR • Real-world • Real-world evidence • Acromegaly • Endocrine Disorders • IGF1 • SSTR

Medical treatment in acromegaly: a network meta-analysis. (PubMed, Eur J Endocrinol) - "Our findings suggest pasireotide LAR and pegvisomant as the most effective treatments for IGF-1 normalization. Pasireotide LAR was the best treatment for tumor shrinkage, though the evidence base was limited, requiring cautious interpretation. Their potential role as first-line options after surgery requires further research. Clinical decisions should consider cost, safety and patient-specific parameters to optimize outcomes."

Journal • Retrospective data • Acromegaly • Endocrine Disorders • Oncology • Pituitary Gland Carcinoma • Rare Diseases • IGF1

Long-Term Antitumour Effects of Pasireotide in Acromegaly. (PubMed, Eur J Endocrinol) - "Pasireotide appears to induce durable cystic degeneration in somatotroph tumours, with evidence suggesting sustained antitumor effects that may extend beyond treatment discontinuation. These findings support its potential for a broader therapeutic role, warranting validation in future prospective studies."

Journal • Acromegaly • Endocrine Disorders • Oncology • Pituitary Gland Carcinoma • IGF1 • SSTR

Pasi-Bone: Effects of Pasireotide Lar Therapy on Bone Metabolism (clinicaltrials.gov) - P=N/A | N=120 | Recruiting | Sponsor: Fondazione Policlinico Universitario Agostino Gemelli IRCCS

New trial • Acromegaly • Endocrine Disorders • Pituitary Gland Carcinoma

The Combination Therapy of Pasireotide LAR Plus Pegvisomant and Cabergoline Relieved Acromegaly-Related Headache in a Female Patient with AIP-Mutated Acromegaly: A Case Report. (PubMed, Endocr Metab Immune Disord Drug Targets) - "This case report highlights the potential benefits of pasireotide in the treatment of refractory headaches, particularly when combined with pegvisomant.  ."

Journal • Acromegaly • Endocrine Disorders • Pain • Pituitary Gland Carcinoma • IGF1 • SSTR

Long-Term Safety of Pasireotide in Patients With Cushing's Disease: Final Results From a 10-Year Open-Label Phase IV Rollover Study (B2412) (ENDO 2025) - P4 | "Data are reported for CD pts from 4 parent studies who received pasireotide long-acting release (LAR; n=33) or subcutaneous (sc; n=29) and ≥1 dose during the rollover (except for 1 pt who only received pasireotide sc in the parent study). Pasireotide is a well-tolerated long-term treatment option for CD pts, with pts having received treatment for ≤16 years from parent study entry. Few pts discontinued because of AEs, including hyperglycemia, and hyperglycemia was infrequent during the study."

Clinical • P4 data • Acromegaly • Back Pain • Colon Cancer • Colorectal Cancer • Cushing’s Disease • Diabetes • Endocrine Disorders • Gastroenterology • Hypoglycemia • Infectious Disease • Metabolic Disorders • Musculoskeletal Pain • Nephrology • Oncology • Pain • Pneumonia • Respiratory Diseases • Septic Shock • Solid Tumor • SSTR

Impact of pasireotide on lipid and glucose metabolism in patients with acromegaly: a systematic review and meta-analysis. (PubMed, J Endocrinol Invest) - "In this large meta-analysis, PasiLAR was associated with increased HDL-C, FPG, HbA1c, and frequency of DM in patients with acromegaly. There was no effect on triglycerides, total cholesterol, and LDL-C."

Journal • Retrospective data • Review • Acromegaly • Diabetes • Dyslipidemia • Endocrine Disorders • Metabolic Disorders

Cardiac Remodelling and Function in a pituitary-specific Aip-knockout Acromegalic Mouse Model: Impact of First- and Second-Generation Somatostatin Analogues. (ESPE-ESE 2025) - "We treated 3-month-old KO-mice with monthly subcutaneous long-acting octreotide (30µg/g), pasireotide (60µg/g) or vehicle injections for 4 months... Pituitary-specific Aip -KO mice develop significant LV hypertrophy and fibrosis, mimicking human ACM. While pasireotide better reduces IGF-1 and weight, octreotide provides superior cardioprotection, suggesting a direct benefit beyond IGF-1 suppression."

Late-breaking abstract • Preclinical • Cardiomyopathy • Cardiovascular • Fibrosis • Immunology • IGF1 • SSTR

Pasireotide Induces Long-term Cystic Degeneration of Somatotrophic Pituitary Neuroendocrine Tumors (PitNETs) (ESPE-ESE 2025) - "Background: Pasireotide LAR is a long-acting somatostatin analog with potential antitumor activity, as demonstrated by treatment induced increased MRI T2-signal intensity of somatotrophic PitNETs (1), but long- term follow-up data are lacking. Forty-four patients, 43 % female, median (IQR) age 52 (15 years) were included. Median treatment duration was 31.0 months. The median IR of the PitNETs increased between baseline and MRI at 7 years (1.09 vs."

Acromegaly • Endocrine Cancer • Endocrine Disorders • Neuroendocrine Tumor • Oncology • Solid Tumor • IGF1

TREATMENT-RESISTANT GH-SECRETING PITUITARY ADENOMA IN YOUNG PATIENT HARBORING A VARIANT SOMATIC MUTATION OF THE GNAS GENE: A CASE REPORT (ESPE-ESE 2025) - "A second transsphenoidal surgery and monthly octreotide LAR (20–60 mg) failed to achieve biochemical control, with a nadir GH of 5.42 ng/mL and IGF-1 of 602 ng/mL. Pasireotide LAR and bromocriptine were administered, but GH levels fluctuated between 1.79–7.15 ng/mL and IGF-1 remained at 555–575 ng/mL...Pegvisomant was considered but unavailable... We report a treatment-resistant GH-secreting pituitary adenoma in a pediatric patient harboring a somatic GNAS mutation. Managing such cases remains challenging, particularly in children. Stereotactic or proton radiotherapy should be considered when surgery and medical therapy fail to achieve biochemical control."

Case report • Clinical • Pain • Pediatrics • Pituitary Gland Carcinoma • GNAS • IGF1 • SSTR

Long-term safety of pasireotide in patients with acromegaly: Final results from a 10-year open-label Phase IV rollover study (B2412) (ESPE-ESE 2025) - P4 | "Here, we report data from the final analysis in patients with acromegaly who received pasireotide long-acting release (LAR) during the rollover. Pasireotide is a well-tolerated long-term treatment option for patients with acromegaly, with patients having received treatment for ≤17 years from parent study entry. Hyperglycaemia was infrequent, and AEs, including hyperglycaemia, were mostly manageable without treatment discontinuation during the rollover."

Clinical • P4 data • Acromegaly • Back Pain • Cardiovascular • Congestive Heart Failure • Cushing’s Disease • Diabetes • Endocrine Disorders • Growth Hormone Deficiency • Heart Failure • Hypertension • Infectious Disease • Metabolic Disorders • Musculoskeletal Pain • Novel Coronavirus Disease • Pain • Pulmonary Embolism • Respiratory Diseases • SSTR

A Case of Aggressive AIP-Mutated Pituitary Acrogigantism Treated with Pasireotide. (ESPE-ESE 2025) - "Due to his hyperprolactinemia, cabergoline was started and rose to a dose of 0.5-1.0 mg/day. Pasireotide long-acting release treatment may be beneficial in AIP mutated patients with acrogigantism and positive immunohistochemical staining of tumour cells for SSTR5."

Clinical • Acromegaly • Anorexia • Back Pain • Cardiovascular • Endocrine Cancer • Endocrine Disorders • Musculoskeletal Pain • Neuroendocrine Tumor • Oncology • Ophthalmology • Pain • Pituitary Gland Carcinoma • Rare Diseases • Solid Tumor • IGF1 • SSTR2 • SSTR5

A persistent headache in acromegalic patient: the positive result of combination therapy with pasireotide LAR, pegvisomant and cabergoline. (ESPE-ESE 2025) - "Pasireotide is known to be able to improve symptoms not sufficiently controlled by fg-SRLs and it can be used as monotherapy or in combination therapy in patients with severe headache not responsive to first-generation SRL therapy, as reported in several studies. Our case report enforces knowledge about pasireotide benefits in headache treatment."

Clinical • Combination therapy • Acromegaly • Endocrine Disorders • Epilepsy • Pain • Pituitary Gland Carcinoma • Ventriculomegaly • IGF1

Impact of Pasireotide LAR on Lipid and Glucose Metabolism in Patients with Acromegaly: a Systematic Review and Meta-analysis (ESPE-ESE 2025) - "This systematic review and meta-analysis is the first comprehensive evaluation of the effects of PasiLAR treatment on both lipid and glucose metabolism in patients with acromegaly. Treatment with PasiLAR for at least 6 months was associated with increased HDL-C, FPG, HbA1c, and frequency of diabetes mellitus in patients with acromegaly. These findings are novel and emphasize the importance of a personalized approach to the treatment of acromegaly with a careful examination of metabolic status, to prevent impairment of lipid and glucose metabolism."

Retrospective data • Review • Acromegaly • Diabetes • Dyslipidemia • Endocrine Disorders • Metabolic Disorders • SSTR