A randomised, double blind, multicentre trial of octreotide in moderate to severe acute pancreatitis.
BACKGROUND
The pharmacological inhibition of exocrine pancreatic secretion with the somatostatin analogue octreotide has been advocated as a specific treatment of acute pancreatitis.


OBJECTIVE
To investigate the efficacy of octreotide in acute pancreatitis in a randomised, placebo controlled trial.


METHODS
302 patients from 32 hospitals, fulfilling the criteria for moderate to severe acute pancreatitis within 96 hours of the onset of symptoms, were randomly assigned to one of three treatment groups: group P (n=103) received placebo, while groups O1 (n=98) and O2 (n=101) received 100 and 200 microg of octreotide, respectively, by subcutaneous injection three times daily for seven days. The primary outcome variable was a score composed of mortality and 15 typical complications of acute pancreatitis.


RESULTS
The three groups were well matched with respect to pretreatment characteristics. An intent to treat analysis of all 302 patients revealed no significant differences among treatment groups with respect to mortality (P: 16%; O1: 15%; O2: 12%), the rate of newly developed complications, the duration of pain, surgical interventions, or the length of the hospital stay. A valid for efficacy analysis (251 patients) also revealed no significant differences.


CONCLUSIONS
This trial shows no benefit of octreotide in the treatment of acute pancreatitis.
Uhl
W
W
Department of Visceral and Transplantation Surgery, University of Bern, Bern, Switzerland.
Büchler
M W
MW
Malfertheiner
P
P
Beger
H G
HG
Adler
G
G
Gaus
W
W
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D010195:Pancreatitis / Q000188:drug therapy*; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D015282:Octreotide