title: Efficacy of the long-acting repeatable formulation of the somatostatin analogue octreotide in postoperative dumping.
abstract: OBJECTIVE
  Several studies have established symptomatic and mechanistic benefits of the somatostatin analogue octreotide in patients with dumping syndrome, but clinical use is hampered by the requirement for subcutaneous administration 3 times daily. We compared the efficacy of subcutaneous octreotide with that of the long-acting repeatable (LAR) octreotide formulation, which is administered monthly, in patients with dumping syndrome.
  
  
  METHODS
  The study included 30 consecutive patients with postoperative dumping, evidenced by oral glucose tolerance test (OGTT) results and insufficient response to dietary measures. OGTT, dumping severity score (summary of scores 0-3 for 8 early and 6 late dumping symptoms), and quality-of-life data were evaluated at baseline, after 3 days of subcutaneous administration of octreotide (0.5 mg), and then after 3 monthly intramuscular injections of octreotide LAR (20 mg).
  
  
  RESULTS
  Both formulations of octreotide significantly reduced total dumping severity scores (21.7 +/- 1.6 at baseline, 11.2 +/- 1.2 for subcutaneous and 14.0 +/- 1.8 for LAR formulations; P < .05). This reduction was associated with significant improvements in the increase in pulse rate (13.8 +/- 5.8 at baseline vs -0.3 +/- 2.2 and 1.9 +/- 1.7; P < .05) as well as the increase in hematocrit level (4.0 +/- 1.4 at baseline vs 0.3 +/- 0.9. and 0.4 +/- 1.0; P < .05), and the lowest glycemia level in the OGTT (54.1 +/- 6.7 at baseline vs 98.9 +/- 7.1 and 67.8 +/- 5.9; P < .05). LAR octreotide administration significantly improved patients' quality of life. Patients' evaluations of their overall treatment efficacy was higher on LAR compared with the subcutaneous formulation (83% vs 52%; P = .01). Gallbladder stones occurred in 4 patients.
  
  
  CONCLUSIONS
  Monthly administration of LAR octreotide improves OGTT results, symptoms, and quality of life in patients with postoperative dumping.
authors.affiliation: Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium.
authors.forename: Joris
authors.initials: J
authors.lastname: Arts
authors.forename: Philip
authors.initials: P
authors.lastname: Caenepeel
authors.forename: Raf
authors.initials: R
authors.lastname: Bisschops
authors.forename: Dominiek
authors.initials: D
authors.lastname: Dewulf
authors.forename: Lieselot
authors.initials: L
authors.lastname: Holvoet
authors.forename: Hubert
authors.initials: H
authors.lastname: Piessevaux
authors.forename: Stefan
authors.initials: S
authors.lastname: Bourgeois
authors.forename: Daniel
authors.initials: D
authors.lastname: Sifrim
authors.forename: Jozef
authors.initials: J
authors.lastname: Janssens
authors.forename: Jan
authors.initials: J
authors.lastname: Tack
mesh_terms: D000328:Adult; D001530:Belgium; D003692:Delayed-Action Preparations / Q000627:therapeutic use*; D004377:Dumping Syndrome / Q000188:drug therapy*; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D015282:Octreotide / Q000627:therapeutic use*; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D003692:Delayed-Action Preparations; D005765:Gastrointestinal Agents; D015282:Octreotide