Abstract |
PASIREOTIDE: This is a novel multireceptor ligand somatostatin (SST) analog with a high binding affinity for SST receptor 5, the predominant receptor in human corticotroph adenomas that is not downregulated by high cortisol levels (as SST receptor 2 is). Pasireotide has been recently approved by the European Medical Agency and the US Food and Drug Administration for treating adults with CD with recurrent hypercortisolism after surgery, or for whom surgery is not an option. A dose of 600-1,200 μg twice a day can normalize urinary free cortisol levels after 3 months of treatment in up to 28% of patients, reducing their blood pressure and improving their weight, lipid profile, and quality of life. Combining pasireotide with cabergoline to achieve a greater hormone response can normalize cortisol secretion in 50% of patients, and adding ketoconazole induces biochemical control in most patients with CD. SAFETY AND HYPERGLYCEMIA: CONCLUSION: In recent years, medical treatment with pasireotide has been proposed as monotherapy for adults with CD characterized by mild to moderate hypercortisolemia, as well as in combination with other available therapies. It is generally well-tolerated, but endocrinologists need to monitor glucose levels to ensure prompt treatment.
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Authors | Filippo Ceccato, Carla Scaroni, Marco Boscaro |
Journal | Therapeutics and clinical risk management
(Ther Clin Risk Manag)
Vol. 11
Pg. 425-34
( 2015)
ISSN: 1176-6336 [Print] New Zealand |
PMID | 25834454
(Publication Type: Journal Article, Review)
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