Pasireotide

Second-generation somatostatin analog; a cyclic six-amino-acid peptide that binds four of the five somatostatin receptors (SSTR1, 2, 3, and 5) with highest affinity for SSTR5. FDA-approved for Cushing's disease (first drug to directly target the pituitary tumor driving cortisol excess) and acromegaly resistant to first-line analogs. Suppresses ACTH output from corticotroph tumors and reduces growth hormone secretion. Known for frequent hyperglycemia due to suppression of insulin and incretin hormones (GLP-1 and GIP).