title: A phase II trial of human secretin infusion for refractory type B pain in chronic pancreatitis.
abstract: OBJECTIVE
  We aimed to determine if intravenous synthetic human secretin (sHS) improves refractory type B pain in patients with chronic pancreatitis (CP).
  
  
  METHODS
  In a phase II dose escalation trial, patients with CP received sHS of varying doses (0.05-0.8 µg/kg) for 3 days. The primary outcomes were changes in the visual analogue pain score (VAS), short form (SF)-36, and opiate use from baseline at 30 days after infusion.
  
  
  RESULTS
  Twelve patients (mean age, 42 years, 6 men) were included. Mean pain scores (VAS) were 5.79, 4.80, 4.72, and 4.90, at baseline, day 4, day 10, and day 30, respectively (P = 0.25, 0.19, and 0.27 when compared with baseline, respectively). Daily opiate use (oral morphine equivalents) decreased throughout the study from a baseline value of 136 to 111 mg on day 4 (P = 0.52) and to 104 mg on day 30 (P = 0.34). In subgroup analysis, women had the most improvement (VAS baseline, 5.42 vs. VAS day 30, 3.67; P = 0.07; baseline morphine equivalents, 107 mg vs. 84 mg; P = 0.21).
  
  
  CONCLUSIONS
  In patients, especially women, with refractory type B pain from CP, intravenous sHS administration demonstrated a trend toward improvement in self-reported pain and opiate use at 30 days after infusion, although statistical significance was not achieved (clinicaltrials.gov registration number NCT01265875).
authors.affiliation: Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Levenick
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Andrews
authors.forename: Edward D
authors.initials: ED
authors.lastname: Purich
authors.forename: Stuart R
authors.initials: SR
authors.lastname: Gordon
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Gardner
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010148:Intractable Pain / Q000188:drug therapy* / Q000503:physiopathology*; D050500:Pancreatitis, Chronic / Q000188:drug therapy* / Q000503:physiopathology*; D011446:Prospective Studies; D012633:Secretin / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000701:Analgesics, Opioid; D012633:Secretin