title: Long acting release-octreotide as "rescue" therapy to control angiodysplasia bleeding: A retrospective study of 98 cases.
abstract: BACKGROUND
  Gastrointestinal angiodysplasias are an important cause of difficult to manage bleeding, especially in older patients.
  
  
  OBJECTIVE
  To retrospectively evaluate the long-term efficacy of long acting release-octreotide in controlling angiodysplasia bleeding.
  
  
  METHODS
  98 patients with a history of bleeding due to gastrointestinal angiodysplasias lasting over 2 years were retrospectively selected among those treated from January 2000 to December 2008. All patients had received octreotide 0.1mg tid for 28 days and, then from day 14, long acting release-octreotide 20mg monthly, for 6 months.
  
  
  RESULTS
  The mean follow-up was 78 months. In all patients mean haemoglobin levels significantly increased and the number of bleeding episodes, hospitalizations, patients requiring blood transfusions and units of transfused red cells significantly decreased, compared to the two-year observation period before starting therapy. According to outcome patients were classified as: 40 full responders (40.8%), 32 relapsers (32.6%) and 26 poor responders (26.5%). At multivariate analysis age >65 years, male sex, chronic antiplatelet therapy, chronic obstructive pulmonary disease and chronic renal failure were the only covariates independently associated with poor response to therapy.
  
  
  CONCLUSIONS
  Our study suggests that long acting release-octreotide could be used as rescue therapy to control bleeding due to gastrointestinal angiodysplasias in patients not suitable for endoscopic or surgical treatments.
authors.affiliation: Department of Clinical Medicine and Surgery, Gastroenterology Unit, University "Federico II", Naples, Italy. Electronic address: nardone@unina.it.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Nardone
authors.affiliation: Department of Clinical Medicine and Surgery, Gastroenterology Unit, University "Federico II", Naples, Italy.
authors.forename: Debora
authors.initials: D
authors.lastname: Compare
authors.affiliation: Laboratory of Clinical Pharmacology, Division of Gastroenterology, Department of Clinical Sciences, University of Parma, Parma, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Scarpignato
authors.affiliation: Department of Clinical Medicine and Surgery, Gastroenterology Unit, University "Federico II", Naples, Italy.
authors.forename: Alba
authors.initials: A
authors.lastname: Rocco
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016888:Angiodysplasia / Q000097:blood / Q000150:complications*; D003692:Delayed-Action Preparations; D017707:Erythrocyte Transfusion; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006471:Gastrointestinal Hemorrhage / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage* / Q000009:adverse effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012008:Recurrence; D051436:Renal Insufficiency, Chronic / Q000150:complications; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D003692:Delayed-Action Preparations; D005765:Gastrointestinal Agents; D010975:Platelet Aggregation Inhibitors; D015282:Octreotide
keywords: Antiplatelet drugs; Gastrointestinal bleeding; Risk score model; Somatostatin analogues