Octreotide Long-Acting Release is effective in preventing gastrointestinal bleeding due to angiodysplasias

BackgroundAngiodysplasias are one of the most frequent causes of gastrointestinal bleeding. Pharmacological options, such as octreotide Long-Acting Release (LAR), do not yet have a defined role and are currently used for patients who are not candidates for or are refractory to endoscopic treatment.Aims(1) To evaluate the efficacy of octreotide LAR by considering transfusion requirements (units of packed erythrocytes (UPE)/month) and number of hospitalizations/month before and during therapy; (2) to verify whether the characteristics of patients and/or concurrent medication influenced response to therapy; and (3) to evaluate the safety of therapy by registering adverse effects.MethodsA retrospective cohort of 16 patients with angiodysplasias treated with octreotide LAR was reviewed.Results(1) There was a significant decrease (follow up before vs. follow up during) in the median number of UPE/month (1.84 vs. 0.42, p=0.008) and the number of admissions/month (0.21 vs. 0.00, p=0.015). (2) Of the characteristics analyzed, only the presence of aortic stenosis (vs. other comorbidities) positively influenced the response to therapy in relation to the variation in transfusion requirements (−2.39UPE/month vs. −0.61UPE/month; p=0.009). (3) Adverse effects: splenic infarction (1 patient) and gallstones (1 patient).ConclusionsOctreotide LAR is effective as prophylaxis for gastrointestinal bleeding angiodysplasia by decreasing transfusion requirements and the need for hospitalizations. Patients with aortic stenosis were those who most benefited from the therapy. A dose of 20mg/month did not prove more effective than a dose of 10mg/month