At a glance
| Products | Signifor; Signifor LAR |
|---|---|
| Receptor profile | Multiple SSTR subtypes, including SSTR5 |
| Uses | Cushing’s disease; LAR also acromegaly |
| Routes | Subcutaneous or intramuscular depot |
| Key adverse effect | Hyperglycemia and diabetes |
Overview
Signifor and Signifor LAR contain pasireotide with different delivery profiles. The immediate-release product is approved for adults with Cushing’s disease when pituitary surgery is unsuitable or not curative. The depot product also has an acromegaly indication after inadequate surgery or when surgery is not an option. Cushing’s disease specifically refers to pituitary ACTH-driven cortisol excess and should not be confused with every form of Cushing’s syndrome. The desired hormonal response can improve illness while simultaneously creating new metabolic problems, so benefit is assessed together with glucose control and other safety measures.
How it works
Pasireotide binds several somatostatin receptor subtypes, with strong activity at SSTR5, which is frequently expressed by corticotroph pituitary tumors. Suppressing ACTH can lower adrenal cortisol secretion. In acromegaly, inhibition of GH secretion reduces downstream IGF-1. Its broader receptor profile differs from octreotide and lanreotide, and suppression of insulin-related pathways contributes to the notable hyperglycemia risk.
Disease and formulation boundaries
Cushing’s disease treatment is aimed at a pituitary source of ACTH excess. The long-acting formulation also treats specified acromegaly populations. Neither is a general treatment for stress-associated cortisol variation or an unexplained abnormal hormone test.
Cortisol-control evidence
The pivotal Cushing’s study assessed urinary free cortisol and clinical changes. Some patients achieved biochemical control, but response was not universal and was influenced by baseline disease severity. That supports monitored treatment rather than an expectation of guaranteed normalization.
Supporting sources [3]
Metabolic and cardiac concerns
Hyperglycemia may appear soon after initiation and can require diabetes treatment. The labels also address bradycardia, QT prolongation, liver-test abnormalities, gallstones and gastrointestinal symptoms. Excess cortisol suppression can produce adrenal insufficiency.
Assessing both benefit and burden
Glucose, HbA1c, liver tests, ECG-related risk and electrolytes are relevant before and during therapy. Hormone response and symptoms are followed alongside adverse effects. New steatorrhea or weight loss can indicate pancreatic exocrine insufficiency.
Why somatostatin analogs differ
Pasireotide, lanreotide and octreotide share a family relationship but have different receptor profiles and approved roles. One agent’s glucose effects or tumor evidence should not be assumed for another, and depot formulations require their own prescribing instructions.
Reading this profile
Jurisdiction: United States — FDA-approved prescription medicine; indication and formulation restrictions apply.. Molecular class: Multireceptor somatostatin analog cyclic hexapeptide.
This profile was written with AI-assisted research and checked against the linked sources. It has not been represented as a clinician’s review. Evidence summaries describe the cited studies and products; they do not establish that a separately purchased preparation is equivalent.
Sources & references
Follow the original material. Product labels define specific formulations and uses; trial registration describes a study and does not by itself establish benefit.
- DailyMed: Signifor current prescribing information ↗Regulatory source · Checked 2026-10-27
- DailyMed: Signifor LAR prescribing information ↗Regulatory source · Checked 2026-10-27
- A 12-month phase 3 study of pasireotide in Cushing's disease. ↗Original research · Checked 2026-10-27