Endocrine Abstracts

Pasireotide (SOM230) is a multireceptor ligand somatostatin analogue with high binding affinity to somatostatin receptor subtype 5, which is predominantly expressed in ACTH-secreting pituitary adenomas. It is indicated for the treatment of adult patients with Cushing’s disease (CD) for whom pituitary surgery is not an option or has not been curative. Our study evaluated the effects of pasireotide, administered for 12 months at a dose of 600–900 μg/daily, in five CD patients with persistent/recurrent disease after pituitary surgery. 24-h urinary free cortisol (UFC) levels, weight, BMI, waist circumference, blood pressure and glucose and lipid metabolism parameters were evaluated in all patients. After 6 months of therapy 4/5 patients (80%) had normal UFC levels, confirmed at 12 months. UFC normalization was associated with a slight improvement in anthropometric values and amelioration of lipid profile. In the remaining 20% of patients (1/5), normalization of UFC levels after 1 month of therapy was followed by escape from response. No patient experienced adrenal insufficiency. Hyperglycaemia due to pasireotide therapy occurred in two patients with normal glucose metabolism prior to treatment. These findings suggest that Pasireotide is an effective treatment for most of the patients with persistent/recurrent CD after surgery.