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 names	Signifor, Signifor LAR
Other names	SOM230
AHFS/Drugs.com	Monograph
License data	US DailyMed: Pasireotide
Pregnancy category	AU: B3
Routes of administration	Subcutaneous injection, intramuscular injection
ATC code	H01CB05 (WHO)
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	396091-73-9 Y
PubChem CID	9941444
IUPHAR/BPS	2018
DrugBank	DB06663 N
ChemSpider	8117062 N
UNII	98H1T17066
KEGG	D10147 N
ChEBI	CHEBI:72312 N
ECHA InfoCard	100.211.883
Chemical and physical data
Formula	C58H66N10O9
Molar mass	1047.227 g·mol−1
3D model (JSmol)	Interactive image
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]