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Efficacy of the long-acting repeatable formulation of the somatostatin analogue octreotide in postoperative dumping.

AbstractBACKGROUND & AIMS:
Several studies have established symptomatic and mechanistic benefits of the somatostatin analogue octreotide in patients with dumping syndrome, but clinical use is hampered by the requirement for subcutaneous administration 3 times daily. We compared the efficacy of subcutaneous octreotide with that of the long-acting repeatable (LAR) octreotide formulation, which is administered monthly, in patients with dumping syndrome.
METHODS:
The study included 30 consecutive patients with postoperative dumping, evidenced by oral glucose tolerance test (OGTT) results and insufficient response to dietary measures. OGTT, dumping severity score (summary of scores 0-3 for 8 early and 6 late dumping symptoms), and quality-of-life data were evaluated at baseline, after 3 days of subcutaneous administration of octreotide (0.5 mg), and then after 3 monthly intramuscular injections of octreotide LAR (20 mg).
RESULTS:
Both formulations of octreotide significantly reduced total dumping severity scores (21.7 +/- 1.6 at baseline, 11.2 +/- 1.2 for subcutaneous and 14.0 +/- 1.8 for LAR formulations; P < .05). This reduction was associated with significant improvements in the increase in pulse rate (13.8 +/- 5.8 at baseline vs -0.3 +/- 2.2 and 1.9 +/- 1.7; P < .05) as well as the increase in hematocrit level (4.0 +/- 1.4 at baseline vs 0.3 +/- 0.9. and 0.4 +/- 1.0; P < .05), and the lowest glycemia level in the OGTT (54.1 +/- 6.7 at baseline vs 98.9 +/- 7.1 and 67.8 +/- 5.9; P < .05). LAR octreotide administration significantly improved patients' quality of life. Patients' evaluations of their overall treatment efficacy was higher on LAR compared with the subcutaneous formulation (83% vs 52%; P = .01). Gallbladder stones occurred in 4 patients.
CONCLUSIONS:
Monthly administration of LAR octreotide improves OGTT results, symptoms, and quality of life in patients with postoperative dumping.
AuthorsJoris Arts, Philip Caenepeel, Raf Bisschops, Dominiek Dewulf, Lieselot Holvoet, Hubert Piessevaux, Stefan Bourgeois, Daniel Sifrim, Jozef Janssens, Jan Tack
JournalClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association (Clin Gastroenterol Hepatol) Vol. 7 Issue 4 Pg. 432-7 (Apr 2009) ISSN: 1542-7714 [Electronic] United States
PMID19264574 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
Chemical References
  • Delayed-Action Preparations
  • Gastrointestinal Agents
  • Octreotide
Topics
  • Adult
  • Belgium
  • Delayed-Action Preparations (therapeutic use)
  • Dumping Syndrome (drug therapy)
  • Female
  • Gastrointestinal Agents (therapeutic use)
  • Glucose Tolerance Test
  • Humans
  • Male
  • Octreotide (therapeutic use)
  • Quality of Life
  • Severity of Illness Index
  • Treatment Outcome

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