SIGNIFOR LAR (pasireotide) for injectable suspension Signifor

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Cases for Consideration PATIENTS WITH ACROMEGALY

In your practice, do you see patients like these?

Each story is unique and all have acromegaly uncontrolled with a first-generation somatostatin analog (SSA). Select a patient to learn more.

Louisa – actor portrayal

Louisa M.

Patient has acromegaly uncontrolled with a first-generation somatostatin analog (SSA).

AGE: 51   |   HEIGHT: 5’4”   |   WEIGHT: 165 lb
DIAGNOSED: 1 year, 8 months ago (20 months) at age 49
SURGERY: None; Louisa is a poor candidate for surgery because of a macroadenoma wrapped around the carotid artery

What do you believe is the appropriate next medical course of therapy?

Patient presents with common acromegaly symptoms and concomitant conditions:

  • Acral enlargement
  • Visual field disturbance
  • Intense back pain
  • Hypertension
  • Congestive heart failure
  • Type 2 diabetes
  • Severe obstructive sleep apnea
  • Depression

Difficulty with activities of daily living:

  • Unable to carry laundry
  • Difficulty buttoning shirts
  • Grocery shopping is becoming hard
    • Difficulty reaching for and grasping groceries

Clipboard iconRELEVANT HISTORY

  • Started on a first-generation SSA, increased to maximum dose, and was in control until recently
    • Began experiencing headaches and other symptoms recently

Pie chart iconBIOCHEMICAL ASSESSMENT

  • GH level: Reached a nadir of 3.5 μg/L 2 hours post-OGGT (GH level for a normal patient would drop below 1 μg/L)
  • IGF-1 concentration: 868 μg/L (4 x ULN for 51-year-old female)

light bulb iconCLINICAL CONSIDERATIONS

Metabolic syndrome

  • Type 2 diabetes (8+ years)
    • HbA1c 7.3, managed with metformin 1000 mg twice daily
  • Hypertension (recent elevations in SBP/DBP noted up to 160/100 mm Hg)
    • Managed with losartan 100 mg once daily and amlodipine besylate 5 mg once daily
  • Hyperlipidemia (LDL = 175,* HDL = 35,* total cholesterol = 210) and hypertriglyceridemia (TRI = 160*)
    • Recently increased to atorvastatin 80 mg once daily
*medlineplus.gov defines LDL of 175 as high, HDL of 35 as a major risk factor for heart attack, and TRI of 160 as borderline high.

Macroadenoma

  • Extends beyond the sella turcica, with cavernous sinus invasion and carotid artery involvement

What are some questions to consider?

Indications and Usage

SIGNIFOR LAR (pasireotide) is a somatostatin analog indicated for the treatment of:

Important Safety Information

Warnings and Precautions

Indications and Usage

SIGNIFOR LAR (pasireotide) is a somatostatin analog indicated for the treatment of:

Important Safety Information

Warnings and Precautions


Adverse Reactions


Drug Interactions


Females and Males of Reproductive Potential


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