Metabolic & endocrine · Growth hormone axis
Pasireotide
A broader-spectrum somatostatin analogue approved for specific endocrine disorders including Cushing's disease.
Also known as: Signifor, Signifor LAR
Evidence passport
Last reviewed 2026-08-23
- Evidence level
- L5Practice-changing
- Confidence
- High confidence
- Human efficacy
- 80/100
- Human safety
- 78/100
- Regulatory status
- Approved — narrow indication
- Development
- Approved
- Routes
- SC injectionIM
- Evidence base
- Includes human data
- Furthest stage
- Approved
- Source curation
- Sources fully curated
- Clinical maturity
- Approved in defined endocrine indications
Overview
Clinical maturity: Approved in defined endocrine indications
Routes & formulations
Studied / approved routes
Immediate-release Signifor is a twice-daily subcutaneous injection; Signifor LAR is a monthly intramuscular depot. The two formulations are distinct approved products.
Route availability is not evidence of efficacy, and evidence from one route does not transfer to another. The Registry never provides dosing or sourcing information.
Peptide lifecycle
Discovery
Preclinical
Phase I
Phase II
Phase III
Approved
What it is
A synthetic somatostatin analogue with wider receptor coverage than octreotide or lanreotide, developed for pituitary-driven hormone disorders.
What people claim
- Reduces cortisol production in Cushing's disease
- Controls growth hormone in acromegaly
What the evidence actually says
Controlled trials supported its approvals. Its broader receptor binding comes with a distinct metabolic cost: hyperglycaemia is a prominent labelled effect.
Human evidence
- Randomised controlled trials in Cushing's disease and acromegaly supporting approval.
Preclinical evidence
- Somatostatin receptor pharmacology across the SSTR family.
Animal and cell findings are Level 1–2 evidence.
Mechanism and pathways
- Broad SSTR agonism suppresses pituitary ACTH and GH secretion.
Safety and unknowns
- Hyperglycaemia and diabetes are prominent labelled effects requiring monitoring.
- Gallbladder and gastrointestinal effects are shared with the class.
Cancer relevance
No concern identified
Regulatory status
FDA-approved in specific endocrine disorders: Signifor for Cushing's disease, and Signifor LAR for acromegaly (with formulation-specific labelling). Approvals are indication- and formulation-specific.
Evidence grade
Replicated large randomised trials, pivotal Phase 3 programmes, or a major regulatory decision.
What would change our rating?
- Not applicable at this evidence tier.
References and sources
- Regulatory / labelFDA label — Signifor (pasireotide) prescribing information
Source hierarchy: regulatory documents and trial registries first, peer-reviewed work next, sponsor material flagged as non-independent. We never use supplier or clinic marketing as evidence, and where a verified source has not yet been curated we say so rather than inventing one.
Evidence change history
No recorded changes yet. Baseline position set on 2026-08-23.