Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Pasireotide, Octreotide · 4 trials · 1 indication
The primary objective of this study was to compare the percentage of patients achieving biochemical control (defined as mean GH levels \<2.5 µg/L and normalization of sex- and age- adjusted IGF-1) at 24 weeks with pasireotide LAR 40 mg and pasireotide LAR 60 mg separately versus continued treatment with octreotide LAR 30 mg or lanreotide autogel (ATG) 120 mg. The primary efficacy variable is the proportion of patients with a reduction of mean GH levels to \< 2.5 µg/L and normalization of sex- and age-adjusted IGF-1 at 24 weeks.
Percentage of participants with a reduction of mean GH levels to \<2.5μg/L (based on a 5-point 2-hour profile) and normalization of sex- and age-adjusted IGF-1. Post surgery = patients with prior surgery but no previous medical treatment for acromegaly De novo = patients with de novo disease who refused pituitary surgery or for whom pituitary surgery was contraindicated.
A participant was a responder to a dose level if the mean GH level after dosing (t30, t60, t90, and t120) was below/equal to 2.5 microgram/litre (μg/L), and if the mean of IGF-1 of the two pre-dose values (t-30, t-1) was within normal limits for age-sex matched controls. If three or more of t30, t60, t90, or t120 were missing, mean GH was considered missing. If either t-30 or t-1 was missing, mean IGF-1 was considered missing. Pasireotide incident dose classes were defined by total daily doses ranges (\<1200 μg/d, 1200 to \<1500 μg/d, ≥ 1500 μg/d).
| Arm | Type | Description |
|---|---|---|
| Pasireotide LAR 40 mg | EXPERIMENTAL | Supplied in blinded fashion as 20 and 40 mg powder in vials and 2 mL vehicle in ampoule (for reconstitution) |
| Pasireotide LAR 60 mg | EXPERIMENTAL | Supplied in blinded fashion as 20 and 40 mg powder in vials and 2 mL vehicle in ampoule (for reconstitution) |
| Control arm (octreotide or lanreotide) | ACTIVE_COMPARATOR | If a patient is randomized to the open label arm the investigator will either: * be instructed to contact a Novartis delegate to initiate shipment of either octreotide LAR 30 mg or lanreotide ATG 120 mg from a Novartis or designee depot to the site, or * continue to dispense either octreotide LAR 30 mg or lanreotide ATG 120 mg available at the institution to the patient if permitted by local regulations. |
| Pasireotide LAR | EXPERIMENTAL | Patients in this arm received Pasireotide LAR 40 mg im depot injection, blinded, once every 28 days (± 2 days) for 12 months. Dose could be down- or up-titrated to 20 or 60 mg, respectively. Patients who responded to Pasireotide LAR (i.e. the randomized treatment) at the end of the core (Month 12), continued Pasireotide LAR treatment in the extension. Patients who did not respond to Pasireotide LAR at the end of the core (Month 12) were allowed to switch to receive Octreotide LAR in the extension. |
| Octreotide LAR | ACTIVE_COMPARATOR | Patients in this arm received Octreotide LAR 20 mg im depot injection, blinded, once every 28 days (± 2 days) for 12 months. Dose could be down- or up-titrated to 10 or 30 mg, respectively. Patients who responded to Octreotide LAR (i.e. the randomized treatment) at the end of the core (Month 12) continued Octreotide LAR treatment in the extension (up to 2 years of treatment). Patients who did not respond to Octreotide LAR at the end of the core (Month 12) were allowed to switch to receive Pasireotide LAR in the extension. |
| Pasireotide s.c. Overall | EXPERIMENTAL | Participants received pasireotide as a daily subcutaneous (s.c) injection, every 12 hours at 9:00 AM and 9:00 PM at the dose at which the biochemical control was achieved (either 200, 400, or 600 microgram (μg)) for as long as the participant benefited from the treatment, and there were no safety or tolerability concerns (median duration of 22.7 months). |
| Sandostatin s.c. (Octreotide) | EXPERIMENTAL | - |
| Pasireotide (SOM230) | EXPERIMENTAL | - |
| Name | Type | Description |
|---|---|---|
| Pasireotide | DRUG | * Double-blind pasireotide LAR 40 mg i.m. injection once every 28 ± 2 days for 24 weeks or * Double-blind pasireotide LAR 60 mg i.m. injection once every 28 ± 2 days for 24 weeks |
| octreotide LAR 30mg | DRUG | In an open-label, active control arm, continue on the same treatment with octreotide LAR 30 mg every 28 ± 2 days as received for at least 6 months prior to randomization |
| lanreotide ATG 120mg | DRUG | In an open-label, active control arm, continue on the same treatment with lanreotide ATG 120 mg every 28 ± 2 days as received for at least 6 months prior to randomization |
| Octreotide | DRUG | Octreotide LAR - i.m. depot injection given once every 28 days. |
| Pasireotide (SOM230), Octreotide (Sandostatin) | DRUG | - |
Inclusion Criteria: 1. Patients with written informed consent prior to any study related activity 2. Patients who had inadequately controlled acromegaly as defined by a mean GH concentration of a 5-point profile over a 2-hour period \> 2.5 µg/L and sex- and age-adjusted IGF-1 \> 1.3 x upper limit o...
Pasireotide is an investigational small molecule being studied for multiple conditions, including hepatic cirrhosis, thyroid cancer, acromegaly, symptomatic refractory resistant carcinoid disease, hyperinsulinemic hypoglycemia, and Cushing's disease. It is developed by Novartis AG and has completed four clinical trials with a total enrollment of 648 participants.
Pasireotide is a somatostatin analog that targets somatostatin receptors. It is being studied for its effects in conditions like acromegaly and carcinoid tumors, where it may help regulate hormone secretion. The drug is administered subcutaneously and is in clinical development for multiple indications.
Pasireotide is developed by Novartis AG, a multinational pharmaceutical company traded under the ticker symbol NVS. The drug is currently in clinical development and has completed trials in the United States and other countries for conditions such as acromegaly and carcinoid tumors.
Pasireotide is in Phase 1 clinical development, though it has completed trials in Phase 2 and Phase 3. The most recent trial, a pharmacokinetics study in hepatic impairment, was Phase 1. All four trials are completed, and the drug remains investigational, not yet approved by regulatory authorities.
Pasireotide has completed four clinical trials: NCT00088582 (Phase 2, acromegaly, 62 participants), NCT00088595 (Phase 2, metastatic carcinoid tumors, 45 participants), NCT00690430 (Phase 3, symptomatic refractory resistant carcinoid disease, 186 participants), and NCT00698464 (Phase 1, hepatic cirrhosis, 34 participants). All trials are completed.
Pasireotide is also known as SOM230, as indicated in clinical trial titles. For example, NCT00088582 refers to SOM230 in acromegalic patients, and NCT00698464 evaluates subcutaneous pasireotide (SOM230). Both names refer to the same investigational drug developed by Novartis.