Abstract | BACKGROUND & 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.
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Authors | Joris Arts, Philip Caenepeel, Raf Bisschops, Dominiek Dewulf, Lieselot Holvoet, Hubert Piessevaux, Stefan Bourgeois, Daniel Sifrim, Jozef Janssens, Jan Tack |
Journal | Clinical 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 |
PMID | 19264574
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Chemical References |
- Delayed-Action Preparations
- Gastrointestinal Agents
- Octreotide
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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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