| Pituitary-dependent Cushing's disease
Signifor vs Signifor LAR
Side-by-side clinical, coverage, and cost comparison for pituitary-dependent cushing's disease.Deep comparison between: Signifor vs Signifor Lar with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsSignifor Lar has a higher rate of injection site reactions vs Signifor based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Signifor Lar but not Signifor, including UnitedHealthcare
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Category
Signifor
Signifor Lar
At A Glance
SC injection
Twice daily
Somatostatin analog
IM injection
Every 4 weeks
Somatostatin analog
Indications
- Pituitary-dependent Cushing's disease
- Acromegaly
- Pituitary-dependent Cushing's disease
Dosing
Pituitary-dependent Cushing's disease Initial dose 0.6 mg or 0.9 mg SC twice daily; dose range 0.3-0.9 mg twice daily, titrated based on response and tolerability; moderate hepatic impairment (Child-Pugh B): initial 0.3 mg twice daily, max 0.6 mg twice daily; avoid in severe hepatic impairment (Child-Pugh C).
Acromegaly Initial dose 40 mg by IM injection once every 4 weeks; may increase to maximum 60 mg every 4 weeks based on response and tolerability. Child-Pugh B: initial dose 20 mg, maximum 40 mg once every 4 weeks. Avoid in Child-Pugh C.
Pituitary-dependent Cushing's disease Initial dose 10 mg by IM injection once every 4 weeks; may increase up to maximum 40 mg once every 28 days based on response and tolerability. Child-Pugh B: initial dose 10 mg, maximum 20 mg once every 4 weeks. Avoid in Child-Pugh C.
Contraindications
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Adverse Reactions
Most common (>=20%) Diarrhea, nausea, hyperglycemia, cholelithiasis, headache, abdominal pain, fatigue, diabetes mellitus
Serious Hypocortisolism, hyperglycemia and diabetes, bradycardia, QT prolongation, liver test elevations, cholelithiasis complications, pituitary hormone deficiency, steatorrhea and malabsorption of dietary fats
Postmarketing Cholelithiasis resulting in complications including cholecystitis and cholangitis, sometimes requiring cholecystectomy
Most common (>=5%) Hyperglycemia, diabetes mellitus, diarrhea, cholelithiasis, headache, nausea, abdominal pain, fatigue, alopecia, sinus bradycardia, nasopharyngitis, blood creatine phosphokinase increased
Serious Hyperglycemia, ketoacidosis, bradycardia, QT prolongation, liver test elevations, cholelithiasis and complications, pituitary hormone deficiency, steatorrhea and malabsorption of dietary fats
Postmarketing Cholelithiasis resulting in complications including cholecystitis and cholangitis, sometimes requiring cholecystectomy
Pharmacology
Somatostatin analog that binds and activates somatostatin receptor subtypes SSTR1, 2, 3, and 5, with highest affinity for SSTR5, inhibiting ACTH secretion from corticotroph tumor cells and thereby reducing cortisol production.
Pasireotide is a somatostatin analog (cyclohexapeptide) that binds with high affinity to somatostatin receptor subtypes SSTR1, 2, 3, and 5, inhibiting GH secretion in acromegaly and ACTH secretion in Cushing's disease via SSTR2 and SSTR5 activation, leading to decreased cortisol secretion.
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Most Common Insurance
Anthem BCBS
Signifor
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (9/12)
Signifor Lar
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Signifor
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (2/8)
Signifor Lar
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Signifor
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (2/3)
Signifor Lar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Cushing's Disease or Cushing's Syndrome
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: Acromegaly: Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.