title: Prevention of severe acute pancreatitis with octreotide in obese patients: a prospective multi-center randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the efficacy of octreotide in preventing severe acute pancreatitis (SAP) in obese patients.
  
  
  METHODS
  A prospective multi-center partly randomized control trial was conducted in patients with mild acute pancreatitis (AP). Nonobese patients received conventional management (nonobese-C, n = 82), whereas obese patients (body mass index ≥ 25 kg/m(2)) were randomized into 2 groups: obese-C (n = 79), who received conventional management, and obese-C+O (n = 82), who received conventional management plus intravenous infusion of octreotide, 50 μg/h for 72 hours.
  
  
  RESULTS
  The risk ratio and relative risk reduction in the development of SAP in the obese-C+O group were 0.27 (95% confidence interval, 0.10-0.69) and 0.73 (95% confidence interval, 0.31-0.90), respectively. The number of cases developing local complications in the obese-C+O group was significantly smaller than that in the obese-C group: 4.9% vs 19%, P = 0.006. The plasma level of somatostatin in the obese-C+O group was significantly higher than that in the obese-C group: 165.5 ± 42.6 vs 112.1 ± 24.86 pg/mL, P < 0.05. Supplement of octreotide also accompanied with reduction in plasma levels of tumor necrosis factor α and IL-6.
  
  
  CONCLUSIONS
  Intravenous administration of octreotide (50 μg/h) for 72 hours in the early stage of AP could prevent the development of SAP effectively in obese patients by raising plasma somatostatin to a normal level and reducing circulating cytokines.
authors.affiliation: Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Yang
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
authors.forename: Yanqing
authors.initials: Y
authors.lastname: Li
authors.forename: Zhaoshen
authors.initials: Z
authors.lastname: Li
authors.forename: Chunhui
authors.initials: C
authors.lastname: Wang
authors.forename: Jinlin
authors.initials: J
authors.lastname: Yang
authors.forename: Bing
authors.initials: B
authors.lastname: Hu
authors.forename: Zhiyin
authors.initials: Z
authors.lastname: Huang
authors.forename: Rui
authors.initials: R
authors.lastname: Ji
authors.forename: Xianbao
authors.initials: X
authors.lastname: Zhan
authors.forename: Huizhong
authors.initials: H
authors.lastname: Xie
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Mingguang
authors.initials: M
authors.lastname: Zhang
authors.forename: Chengwei
authors.initials: C
authors.lastname: Tang
mesh_terms: D000328:Adult; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D015282:Octreotide / Q000627:therapeutic use*; D010195:Pancreatitis / Q000188:drug therapy / Q000517:prevention & control*; D012720:Severity of Illness Index; D013004:Somatostatin / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D005765:Gastrointestinal Agents; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D013004:Somatostatin; D015282:Octreotide