Pasireotide

Pasireotide, sold under the brand name Signifor, is an orphan drug approved in the United States[1] and the European Union[2][3] for the treatment of Cushing's disease in patients who fail or are ineligible for surgical therapy.[4][5][6] It was developed by Novartis. Pasireotide is a somatostatin analog with a 40-fold increased affinity to somatostatin receptor 5 compared to other somatostatin analogs.

Pasireotide
Clinical data
Trade namesSignifor, Signifor LAR
Other namesSOM230
AHFS/Drugs.comMonograph
License data
Pregnancy
category
  • AU: B3
Routes of
administration		Subcutaneous injection, intramuscular injection
ATC code
Legal status
Legal status
  • UK: POM (Prescription only)
  • US: ℞-only
  • EU: Rx-only
  • In general: ℞ (Prescription only)
Identifiers
IUPAC name
  • [(3S,6S,9S,12R,15S,18S,20R)-9-(4-aminobutyl)-3-benzyl-12-(1H-indol-3-ylmethyl)-2,5,8,11,14,17-hexaoxo-15-phenyl-6-[(4-phenylmethoxyphenyl)methyl]-1,4,7,10,13,16-hexazabicyclo[16.3.0]henicosan-20-yl] N-(2-aminoethyl)carbamate
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ECHA InfoCard100.211.883
Chemical and physical data
FormulaC58H66N10O9
Molar mass1047.227 g·mol−1
3D model (JSmol)
SMILES
  • C1[C@H](CN2[C@@H]1C(=O)N[C@H](C(=O)N[C@@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C2=O)CC3=CC=CC=C3)CC4=CC=C(C=C4)OCC5=CC=CC=C5)CCCCN)CC6=CNC7=CC=CC=C76)C8=CC=CC=C8)OC(=O)NCCN
InChI
  • InChI=1S/C58H66N10O9/c59-27-13-12-22-46-52(69)64-47(30-38-23-25-42(26-24-38)76-36-39-16-6-2-7-17-39)53(70)66-49(31-37-14-4-1-5-15-37)57(74)68-35-43(77-58(75)61-29-28-60)33-50(68)55(72)67-51(40-18-8-3-9-19-40)56(73)65-48(54(71)63-46)32-41-34-62-45-21-11-10-20-44(41)45/h1-11,14-21,23-26,34,43,46-51,62H,12-13,22,27-33,35-36,59-60H2,(H,61,75)(H,63,71)(H,64,69)(H,65,73)(H,66,70)(H,67,72)/t43-,46+,47+,48-,49+,50+,51+/m1/s1 N
  • Key:VMZMNAABQBOLAK-DBILLSOUSA-N N
 NY (what is this?)  (verify)

The most common side effects include hyperglycaemia (high blood sugar levels), diabetes, diarrhoea, abdominal pain (stomach ache), nausea (feeling sick), cholelithiasis (gallstones), injection site reactions, and tiredness.[2][7][8]

Pasireotide was approved for Cushing's disease by the European Medicines Agency (EMA) in April 2012[2][9] and by the U.S. Food and Drug Administration (FDA) in December 2012.[1][10]

Pasireotide LAR (the long-acting-release formulation) was approved by the FDA for treatment of acromegaly in December 2014,[11] and had been approved for this indication by the EMA in September 2014.[2][12]

References
  1. "Drug Approval Package: Signifor (pasireotide) Injection NDA #200677". U.S. Food and Drug Administration (FDA). 24 December 1999. Retrieved 13 May 2020.
  2. "Signifor EPAR". European Medicines Agency (EMA). Retrieved 13 May 2020. Text was copied from this source which is © European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  3. "Summary of Product Characteristics: Signifor" (PDF). European Medicines Agency.
  4. "Pasireotide Orphan Drug Designation and Approval". U.S. Food and Drug Administration (FDA). 24 December 1999. Retrieved 13 May 2020.
  5. "EU/3/09/671". European Medicines Agency. 17 September 2018. Retrieved 13 May 2020. Text was copied from this source which is © European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  6. Mancini T, Porcelli T, Giustina A (October 2010). "Treatment of Cushing disease: overview and recent findings". Therapeutics and Clinical Risk Management. 6: 505–16. doi:10.2147/TCRM.S12952. PMC 2963160. PMID 21063461.
  7. "Signifor- pasireotide injection". DailyMed. 15 January 2020. Retrieved 13 May 2020.
  8. "Signifor LAR- pasireotide kit". DailyMed. 17 December 2019. Retrieved 13 May 2020.
  9. EMEA Approval for Pasireotide
  10. "FDA Approves Pasireotide for Cushing's Disease".
  11. "Signifor LAR (pasireotide) for injectable suspension". U.S. Food and Drug Administration (FDA). 1 March 2016. Retrieved 13 May 2020.
  12. Tucker ME (17 December 2014). "FDA Approves Pasireotide for Treating Acromegaly". Medscape. Retrieved 2 August 2015.
  • "Pasireotide". Drug Information Portal. U.S. National Library of Medicine.


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