Pasireotide (SOM230): a novel pituitary-targeted medical therapy for the treatment of patients with Cushing’s disease

Abstract

Cushing’s disease (CD) is a rare and debilitating condition resulting from extended exposure to excessive glucocorticoids caused by an adrenocorticotropic hormone-secreting pituitary adenoma. First-line treatment for most patients with CD is trans-sphenoidal adenomectomy. Postsurgical remission remains problematic; however, due to the difficulty of removing the tumor. Until recently, there were no approved medical treatments for Cushing’s syndrome, but recent data on pasireotide (SOM230; a novel somatostatin analog) demonstrate restored hormone levels and improvements in quality of life, with a safety profile similar to that of other somatostatin analogs, except for incidence of hyperglycemia. Pasireotide represents an exciting, novel, pituitary-targeted medical therapy for patients with CD who are not surgical candidates, or for those who experience postsurgical recurrence.

Keywords::

• Cushing’s disease
• hypercortisolism
• medical therapy
• pasireotide
• somatostatin analog

Financial & competing interests disclosure

Financial support for editorial and administrative assistance was provided by Novartis Pharmaceuticals Corporation. WH Ludlam has received consultant fees, and is a principal investigator in clinical trials sponsored by Novartis. WH Ludlam is currently an employee of Novartis, but was not so affiliated during the preparation of this manuscript. M Mayberg has received grant support from the NIH (R01 NS046513-01). The authors are solely responsible for all content. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

The authors would like to thank T Remus and D Wolff (Mudskipper Inc., IL, USA) for editorial assistance with this manuscript.