Tirzepatide for pasireotide-induced hyperglycemia in a GH/TSH-producing pituitary adenoma/PitNET: a case report and literature review
Abstract
Pasireotide, a somatostatin analog with high affinity for somatostatin receptor 5 (SSTR5), is frequently used to treat residual or recurrent pituitary adenomas, but it often induces hyperglycemia by suppressing glucagon-like peptide-1 (GLP-1) secretion. Although GLP-1 receptor agonists (GLP-1RAs) have been reported to be effective for pasireotide-induced hyperglycemia, no established treatment strategy currently exists. The present report describes the first documented use of once-weekly subcutaneous tirzepatide in a patient with pasireotide-induced hyperglycemia that remained inadequately controlled despite oral GLP-1RA therapy. A 48-year-old woman without a history of glucose intolerance was diagnosed with a GH/TSH-producing pituitary adenoma/PitNET. Transsphenoidal surgery was performed, followed by initiation of pasireotide for the residual tumor. Subsequently, the patient developed progressive hyperglycemia, with the hemoglobin A1c (HbA1c) level increasing from 6.5% to 7.7%. Oral sitagliptin and semaglutide were sequentially introduced; however, glycemic control remained suboptimal. Upon switching to once-weekly subcutaneous tirzepatide, the HbA1c level decreased markedly from 7.7% to 6.3%, along with an improvement in random blood glucose levels. In conclusion, once-weekly subcutaneous tirzepatide may be a therapeutic option for selected patients with pasireotide-induced hyperglycemia. However, further studies are needed to determine whether its effects differ from those of intensified GLP-1RA therapy.
Related
- Anti–pituitary-specific transcription factor-1 hypophysitis developing after thymoma resection: a case report with review of literature
- Aldosterone-producing adrenocortical carcinoma presenting with severe, rapidly progressive hypokalemia: a case report and literature review
- Burosumab-responsive micro tumor-induced osteomalacia caused by a 6-mm phosphaturic mesenchymal tumor of the femoral head: a case report with review of literature on small (≤10 mm) FGF23-producing tumors
- GLP-1 receptor agonists counteract the detrimental effects of pasireotide on pancreatic beta-cell function and survival
- Case Report: Neurosurgery, octreotide, cabergoline, radiotherapy, pasireotide and pegvisomant – a multimodal strategy for adolescent acrogigantism
BibTeX
@article{iwamoto2026tirzepatide,
title = {{Tirzepatide for pasireotide-induced hyperglycemia in a GH/TSH-producing pituitary adenoma/PitNET: a case report and literature review}},
author = {Yuichiro Iwamoto and Kaoru Yamashita and Yasufumi Seki and Kosaku Amano and Atsuhiro Ichihara and Hideaki Kaneto},
journal = {Endocrine Journal},
year = {2026},
month = sep,
doi = {10.1507/endocrj.ej26-0396},
url = {https://www.jstage.jst.go.jp/article/endocrj/advpub/0/advpub_EJ26-0396/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Tirzepatide for pasireotide-induced hyperglycemia in a GH/TSH-producing pituitary adenoma/PitNET: a case report and literature review
AU - Yuichiro Iwamoto
AU - Kaoru Yamashita
AU - Yasufumi Seki
AU - Kosaku Amano
AU - Atsuhiro Ichihara
AU - Hideaki Kaneto
PY - 2026
DA - 2026/09/12
JO - Endocrine Journal
DO - 10.1507/endocrj.ej26-0396
UR - https://www.jstage.jst.go.jp/article/endocrj/advpub/0/advpub_EJ26-0396/_article
AB - Pasireotide, a somatostatin analog with high affinity for somatostatin receptor 5 (SSTR5), is frequently used to treat residual or recurrent pituitary adenomas, but it often induces hyperglycemia by suppressing glucagon-like peptide-1 (GLP-1) secretion. Although GLP-1 receptor agonists (GLP-1RAs) have been reported to be effective for pasireotide-induced hyperglycemia, no established treatment strategy currently exists. The present report describes the first documented use of once-weekly subcutaneous tirzepatide in a patient with pasireotide-induced hyperglycemia that remained inadequately controlled despite oral GLP-1RA therapy. A 48-year-old woman without a history of glucose intolerance was diagnosed with a GH/TSH-producing pituitary adenoma/PitNET. Transsphenoidal surgery was performed, followed by initiation of pasireotide for the residual tumor. Subsequently, the patient developed progressive hyperglycemia, with the hemoglobin A1c (HbA1c) level increasing from 6.5% to 7.7%. Oral sitagliptin and semaglutide were sequentially introduced; however, glycemic control remained suboptimal. Upon switching to once-weekly subcutaneous tirzepatide, the HbA1c level decreased markedly from 7.7% to 6.3%, along with an improvement in random blood glucose levels. In conclusion, once-weekly subcutaneous tirzepatide may be a therapeutic option for selected patients with pasireotide-induced hyperglycemia. However, further studies are needed to determine whether its effects differ from those of intensified GLP-1RA therapy.
SN - 1348-4540
SN - 0918-8959
ER -