Meta-analysis: octreotide prevents post-ERCP pancreatitis, but only at sufficient doses.
BACKGROUND
Effects of octreotide on post-endoscopic retrograde cholangiopancreatography pancreatitis have been studied in many clinical trials. These trials have yielded inconclusive results. Results of more recent studies using larger doses, however, seem to be more optimistic.


OBJECTIVE
To examine effects of octreotide at different doses on PEP.


METHODS
A comprehensive search of relevant databases, including Medline, Embase, the Cochrane Controlled Trials Register, the Cochrane Library and Science Citation Index yielded 18 randomized controlled trials (RCTs). Trials were divided into two groups according to the total dosage of octreotide: <0.5 mg (OCT1), > or =0.5 mg (OCT2). The rate of PEP was analysed using a fixed effect model.


RESULTS
At doses of > or =0.5 mg, octreotide reduced the rate of PEP. In the OCT2 group, analysis revealed a statistically significant difference on PEP between the octreotide group and the controls (3.4% vs. 7.5%, pooled OR = 0.45; 95% CI: 0.28-0.73; P = 0.001, NNT = 25). In the OCT1 group, the rate of PEP was similar between patients receiving octreotide and the controls (7.2% vs. 6.0%, pooled OR = 1.23; 95% CI: 0.80-1.91; P = 0.35).


CONCLUSIONS
Octreotide is effective in preventing PEP, but only at sufficient doses (> or =0.5 mg).
Zhang
Y
Y
Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Chen
Q-B
QB
Gao
Z-Y
ZY
Xie
W-F
WF
D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D015282:Octreotide / Q000008:administration & dosage*; D016017:Odds Ratio; D010195:Pancreatitis / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D015282:Octreotide