Document Detail


Octreotide for the treatment of diarrhea in patients with ileal pouch anal anastomosis: a placebo controlled cross-over study.
MedLine Citation:
PMID:  21951549     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background and aim:  Diarrhea and urgency is a debilitating long term complication of ileal pouch anal anastomosis (IPAA) after a proctocolectomy. Somatostatin analogues are used to control diarrhea and high output ostomies. Hence, we designed a prospective, double blind, cross-over trial to explore the efficacy and tolerability of octreotide to reduce diarrhea in adult patients with IPAA. Methods:  Patients were randomized to octreotide SC 500 μg tid or matching placebo SC for 7 days. Responders (reduction in stool frequency of ≥3 and ≥30%, primary endpoint) remained in the same group and non-responders could cross over to the alternative treatment for 7 days. Open label octeotide LAR 30 mg was offered to all responders on day 14. Flexible pouchoscopy with biopsies was performed at baseline in all patients and repeated on day 7, 14 in patients with pouchitis. Results:  Fifteen patients (11 male, median age 52 yrs), all UC, were randomized. Three patients were withdrawn for side effects during the blinded phase. Response was reached by 2/12 and 2/11patients treated with octreotide or placebo respectively (including cross-over, p=0.9). Median stool frequency remained stable in both groups [Δoctreotide: 0 (IQR -4 to 0), ΔPlacebo: -1 (IQR -1 to 1), p=0.45]. Octreotide had no effect on the Modified pouch disease activity index (mPDAI) and pouchitis persisted in 5/6 subjects with pouchitis at onset. One received open label octreotide LAR. Conclusion:  Octreotide has no clear beneficial effect on the stool pattern nor on pouchitis severity in patients with high stool frequency after IPAA.
Authors:
Gert Van Assche; Marc Ferrante; Séverine Vermeire; Maja Noman; Karen Rans; Leen Van der Biest; Freddy Penninckx; Albert Wolthuis; Paul Rutgeerts; André D'Hoore
Related Documents :
21971489 - Multisession radiosurgery for optic nerve sheath meningiomas-an effective option: preli...
21906429 - Efficacy and safety of ultrasound-guided local injections of etanercept into entheses o...
21659439 - Tissue coverage of a hydrophilic polymer-coated zotarolimus-eluting stent vs. a fluorop...
22205469 - Neodymium:yag laser treatment of lower leg telangiectasia: a new minimally invasive app...
22027879 - Health-related quality of life after burns: a prospective multicentre cohort study with...
21927109 - Role of ect phenothiazine combination in schizophrenia.
9565739 - Safety review of adult clinical trial experience with lamotrigine.
2217669 - A study to assess the efficacy of chemoprophylaxis in the prevention of endoscopy-relat...
25041759 - Thrombolysis in patients with prior stroke within the last 3 months.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-23
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  -     ISSN:  1463-1318     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 The Association of Coloproctology of Great Britain and Ireland.
Affiliation:
From the division of Abdominal Surgery Gastroenterology. University of Leuven Hospitals. Leuven 3000, Belgium.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Sex difference in lipid profile in relation to the progression of glucose abnormalities.
Next Document:  The clinical features of the overlap between COPD and asthma.