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Metabolic & endocrine · Growth hormone axis

Pasireotide

A broader-spectrum somatostatin analogue approved for specific endocrine disorders including Cushing's disease.

L5Practice-changingApproved — narrow indicationApprovedHigh confidenceLast reviewed 2026-08-23
SC injectionIM

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

Human evidence80/100
Preclinical evidence78/100
Human safety evidence78/100

Clinical maturity: Approved in defined endocrine indications

Routes & formulations

Studied / approved routes

SC injectionIM

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

  1. Discovery

  2. Preclinical

  3. Phase I

  4. Phase II

  5. Phase III

  6. Approved

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

No established human cancer signal; used to treat hormone-secreting pituitary disease.

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

L5Practice-changingHigh confidence

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

Sources fully curated

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.