Prevention of severe acute pancreatitis with octreotide in obese patients: a prospective multi-center randomized controlled trial

Pancreas. 2012 Nov;41(8):1206-12. doi: 10.1097/MPA.0b013e3182523bdf.

Abstract

Objectives: 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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Obesity / complications*
  • Octreotide / therapeutic use*
  • Pancreatitis / drug therapy
  • Pancreatitis / prevention & control*
  • Severity of Illness Index
  • Somatostatin / blood
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Gastrointestinal Agents
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • Somatostatin
  • Octreotide