[Octreotide long acting release for severe obscure gastrointestinal haemorrhage in elderly patients with serious comorbidities].
OBJECTIVE
Octreotide LAR has shown preliminary promising results in the treatment of recurrent obscure gastrointestinal haemorrhage.


METHODS
Eleven patients with severe comorbidities were treated with continuous octreotide LAR 20mg once a month. No changes were performed in concomitant drugs. Haemoglobin levels, blood transfusions, hospital admissions and adverse effects were recorded every three months.


RESULTS
Median age and follow-up were 74 yr (65-86) and 15 months (5-48). Five patients were on acenocoumarol therapy and other five on antiplatelet drugs. Eight patients (72%) had diffuse small bowel angiodysplasia and 4 patients died during follow-up. Only two patients (18%) remained free of transfusions but it resulted for the first year in an outstanding decrease in the need of red cell packets (14 (9-49) vs 4 (0-9), p=0,002) and in admission days related to gastrointestinal bleeding (27 (10-99) vs 7(0-23), p=0,001). No side effects were reported.


CONCLUSIONS
Octreotide LAR is an effective, safe and comfortable palliative therapy for severe obscure gastrointestinal bleeding. Medical resources saving and improved quality of life may warrant its use irrespective of comorbidities or life expectancy.
Unidad de Aparato Digestivo, Hospital San Pedro de Alcántara, Cáceres, España. xavi_molina@hotmail.com
Javier
J
Molina Infante
Belén
B
Pérez Gallardo
Moisés
M
Hernández Alonso
José María
JM
Mateos Rodríguez
Carmen
C
Dueñas Sadornil
Miguel
M
Fernández Bermejo
D000368:Aged; D000369:Aged, 80 and over; D003692:Delayed-Action Preparations; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D015282:Octreotide / Q000627:therapeutic use*; D011446:Prospective Studies; D012720:Severity of Illness Index; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
D003692:Delayed-Action Preparations; D014662:Vasoconstrictor Agents; D015282:Octreotide