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The effects of vapreotide, a somatostatin analogue, on gastric acidity, gallbladder emptying and hormone release after 1 week of continuous subcutaneous infusion in normal subjects
Author(s) -
Ritz Marc Alain,
Drewe Jürgen,
Ziel Annette,
Hildebrand Pius,
Schneider Pierre,
Lahlou Najiba,
Beglinger Christoph
Publication year - 1999
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1046/j.1365-2125.1999.00878.x
Subject(s) - medicine , gastrin , endocrinology , placebo , somatostatin , postprandial , crossover study , cholecystokinin , motilin , gastric emptying , gastrointestinal hormone , peptide hormone , hormone , stomach , receptor , alternative medicine , pathology , secretion , insulin
Aims Somatostatin analogues (e.g. vapreotide) are used for treatment of acromegaly, endocrine tumours and variceal bleeding. The pharmacodynamic effects of vapreotide have, however, not been documented in the gastrointestinal tract. The aim of this study was to investigate the effects of continuous vapreotide administration on gastric acidity, gallbladder contraction and hormone release.Methods Ten healthy males participated in this randomised, placebo‐controlled, double‐blind, crossover trial. A constant vapreotide (or placebo) infusion (1.5 mg day −1 s.c.) was given for 7 days with a portable pump. Intragastric pH was monitored on days 2 and 7. Gallbladder volume was sonographically assessed and the maximal ejection fraction was calculated. In addition basal and postprandial plasma levels of gastrin and cholecystokinin (CCK) were measured.Results After an initial increase in the median 24 h intragastric pH to a value of 2.6 on day 2, vapreotide’s effect on pH decreased: (day 7: median pH=1.9; respective placebo values were 1.7 and 1.5). On the same days with vapreotide treatment, gallbladder contraction and plasma levels of CCK were reduced; maximal ejection fractions after meal stimulation were 18% and 20% (respective placebo values were 57% and 62%). Plasma gastrin levels were not changed with vapreotide treatment.Conclusions The short lasting effect of vapreotide on intragastric acidity suggests a down‐regulation of somatostatin receptors during treatment. The lack of effect on gastrin indicates that the effects on gastric pH are not mediated by gastrin. Constant vapreotide infusion (but not placebo) reduced gallbladder contraction suggesting a long‐lasting effect on biliary function.