Digestion
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Randomized Controlled Trial Multicenter Study Clinical Trial
Efficacy of somatostatin and its analogues in pancreatic surgery and pancreatic disorders.
Major pancreatic resection is still accompanied by considerable morbidity (35%) and mortality (10%). Typical complications, such as pancreatic fistula and abscess, are chiefly associated with exocrine pancreatic secretion. The hormone somatostatin and its analogue octreotide are well known as potent inhibitors of exocrine pancreatic secretion. ⋯ Results were similar in a second study, using the same protocol but recruiting only patients with chronic pancreatitis. A new randomised, controlled multicentre trial is also described, in which 300 patients with severe acute pancreatitis are being treated with or without octreotide in double-blind fashion. The results will clarify the influence of inhibition of exocrine pancreatic secretion by octreotide on the course of acute pancreatitis, and hence its potential, through inhibition of digestive enzyme secretion, as a treatment for acute pancreatitis.
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Multicenter Study Clinical Trial
The use of new somatostatin analogues, lanreotide and octastatin, in neuroendocrine gastro-intestinal tumours.
In an open phase III study, octastatin was given as a continuous subcutaneous (s.c.) infusion to 35 patients (mean age 62 years) with malignant neuroendocrine gastro-intestinal tumours and the carcinoid syndrome. The wash-out was often incomplete because of the advanced stage of disease. The starting dose of 1.5 mg/24 h was increased up to 3.0 mg/24 h at 3 months in some patients. ⋯ U-5-HIAA, which was elevated in 13 patients with a mean of 444 mumol/day before the start, was reduced to 58% of baseline at 3 months, 68% at 6 months (p = 0.04), 66% at 9 months and 75% at 12 months (p = 0.14). P-chromogranin was elevated in 18 patients, with a mean of 5,300 micrograms/l before the start, and was reduced to 52, 55, 63 and 64% of the baseline at 3, 6 (p = 0.039), 9 and 12 (p = 0.013) months, respectively. In the responding patients, apoptosis was induced.