Pasireotide for treating acromegaly

ABSTRACT

Introduction: Uncontrolled acromegaly can lead to serious illness and premature death. Currently, treatment options include surgery, medical therapy and radiotherapy. Somatostatin analogues (SAs) are the medical treatment of choice. Nevertheless, a percentage of patients do not adequately respond to first generation SAs, lanreotide and octreotide, monotherapy. In this context, the multi-ligand SA pasireotide, which has a broader binding profile, appears as an option.

Areas covered: The aim of this paper is to review pasireotide as an option for acromegalic patients. It will provide an overview, emphasizing its mechanism of action, clinical efficacy, adverse effects and indications. In addition to Google Scholar, a PubMed search using key words was conducted, and relevant articles published in English peer-reviewed journals were retrieved. Only those papers that directly addressed pasireotide treatment for acromegaly were retained for extensive review.

Expert opinion: Pasireotide has been shown to overcome resistance to the first generation SAs in a subset of acromegalic patients, becoming an important tool in the treatment algorithm of acromegaly. Nevertheless, due to the higher prevalence of hyperglycemia-related events under its use, in our opinion pasireotide treatment should be reserved for those acromegalic patients inadequately controlled by first generation SAs, lanreotide and octreotide.

KEYWORDS:

• Somatostatin analogues
• acromegaly
• somatostatin receptor subtypes

Declaration of interest

M Bronstein is a consultant and member of steering committees for Chiasma, Ipsen, Novartis, speaker for Ipsen, Novartis and Pfizer, and Principal Investigator for clinical trials with Ipsen and Novartis. R Jallad is a sub-investigator for clinical trials with Ipsen and Novartis. The authors have no other relevant affiliations or financial involvements with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.