Premium
Octreotide in refractory functional epigastric pain with nutritional impairment—an open study
Author(s) -
Ducrotté,
Maillot,
Leroi,
Lalaude,
Colin Colin,
Denis Denis
Publication year - 1999
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.1999.00541.x
Subject(s) - octreotide , medicine , refractory (planetary science) , epigastric pain , surgery , visual analogue scale , weight loss , gastroenterology , somatostatin , obesity , vomiting , physics , astrobiology
Aim : To test the therapeutic efficacy of octreotide administered subcutaneously for the relief of chronic refractory epigastric pain severe enough to provoke nutritional impairment. Subjects and methods : Seventeen patients were enrolled in an open trial. Epigastric pain had lasted from 1 to 8 years (median: 5 years), following anti‐reflux surgery in eight patients. Median weight loss was 10% (range 10–15). The initial dose of octreotide was 50 μg b.d, adjusted during the follow‐up visits which were scheduled for months 1, 3, 6, 8, 10, 12 and every 3 months. At each visit, overall symptomatic improvement, frequency and intensity of symptoms were checked on a 10‐cm visual analogic scale. Results : At month 1, a progressive improvement of pain intensity was reported in 15 of the 17 patients, while octreotide was a therapeutic failure in two. In four out of 15, the daily dose of octreotide was increased to 100 μg b.d. In these 15 patients, median follow‐up was 7 months (3–27). The symptomatic benefit was maintained in each patient at month 3, with a median weight gain of 3.5 kg. 2 [3][Randic M, 1978][4][Bean BP, 1989] –5 An attempt to stop octreotide led to recurrence of symptoms in 2–3 days which were as intense as before the treatment. The 11 patients followed‐up for at least 6 months reported persistent improvement of symptoms with octreotide and a median weight gain of 4 kg. 3 [4][Bean BP, 1989][5][Murase K, 1982][6][Madrazo I, 1987] –7 Four patients were followed up for more 11–27 months: octreotide was withdrawn gradually in two who remained asymptomatic. Six of the 17 patients experienced minor side‐effects, but none developed biliary sludge. Conclusions : This open study suggests that octreotide could be a promising alternative treatment when all others fail in refractory chronic functional epigastric pain severe enough to limit food intake and to induce nutritional impairment. These results must be tested by a placebo‐controlled study.