Prevention of severe acute pancreatitis with octreotide in obese patients: a prospective multi-center randomized controlled trial.

Abstract

OBJECTIVES:

To evaluate the efficacy of octreotide in preventing severe acute pancreatitis (SAP) in obese patients.

METHODS:

A prospective multi-center partly randomized control trial was conducted in patients with mild acute pancreatitis (AP). Nonobese patients received conventional management (nonobese-C, n = 82), whereas obese patients (body mass index ≥ 25 kg/m(2)) were randomized into 2 groups: obese-C (n = 79), who received conventional management, and obese-C+O (n = 82), who received conventional management plus intravenous infusion of octreotide, 50 μg/h for 72 hours.

RESULTS:

The risk ratio and relative risk reduction in the development of SAP in the obese-C+O group were 0.27 (95% confidence interval, 0.10-0.69) and 0.73 (95% confidence interval, 0.31-0.90), respectively. The number of cases developing local complications in the obese-C+O group was significantly smaller than that in the obese-C group: 4.9% vs 19%, P = 0.006. The plasma level of somatostatin in the obese-C+O group was significantly higher than that in the obese-C group: 165.5 ± 42.6 vs 112.1 ± 24.86 pg/mL, P < 0.05. Supplement of octreotide also accompanied with reduction in plasma levels of tumor necrosis factor α and IL-6.

CONCLUSIONS:

Intravenous administration of octreotide (50 μg/h) for 72 hours in the early stage of AP could prevent the development of SAP effectively in obese patients by raising plasma somatostatin to a normal level and reducing circulating cytokines.

• Authors: Fan Yang, Hao Wu, Yanqing Li, Zhaoshen Li, Chunhui Wang, Jinlin Yang, Bing Hu, Zhiyin Huang, Rui Ji, Xianbao Zhan, Huizhong Xie, Lei Wang, Mingguang Zhang, Chengwei Tang
• Journal: Pancreas (Pancreas) Vol. 41 Issue 8 Pg. 1206-12 (Nov 2012) ISSN: 1536-4828 [Electronic] United States
• PMID: 23086244 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Gastrointestinal Agents
• Interleukin-6
• Tumor Necrosis Factor-alpha
• Somatostatin
• Octreotide

Topics

• Adult
• Female
• Gastrointestinal Agents (therapeutic use)
• Humans
• Interleukin-6 (blood)
• Male
• Middle Aged
• Obesity (complications)
• Octreotide (therapeutic use)
• Pancreatitis (drug therapy, prevention & control)
• Severity of Illness Index
• Somatostatin (blood)
• Tumor Necrosis Factor-alpha (blood)