Meta-analysis of somatostatin, octreotide and gabexate mesilate in the therapy of acute pancreatitis

Aliment Pharmacol Ther. 1998 Mar;12(3):237-45. doi: 10.1046/j.1365-2036.1998.00295.x.


Background: Autodigestion of the pancreas, secondary to the activation of digestive enzymes, is the pathogenetic mechanism of acute pancreatitis (AP).

Aim: Clinical trials in which somatostatin (SS), octreotide (OCT) and gabexate mesilate (FOY) were used to treat patients with AP, were submitted to a meta-analytical evaluation. Five end-points were evaluated: early and overall mortality, patients with complications, complication rate, and patients who needed surgery.

Results: In mild AP, no agent proved of value. In severe AP, both SS and OCT were beneficial in improving the overall mortality: the odds ratios (OR) were, respectively, 0.36 (95% CI: 0.20-0.64, P = 0.001) and 0.57 (95% CI: 0.35-0.88, P = 0.006). FOY had no effect on either early or overall mortality, but was effective in improving complication rate (OR = 0.70, 95% CI: 0.56-0.88, P = 0.02), number of patients with complications (OR = 0.61, 95% CI: 0.41-0.91, P = 0.01), and number of cases submitted to surgery (OR = 0.60, 95% CI: 0.39-0.92, P = 0.01). SS and OCT had no effect on these latter outcomes.

Conclusions: Antisecretory agents, such as SS and OCT, are able to reduce mortality without affecting complications, whereas antiproteases, such as FOY, have no effect on mortality but do reduce complications. A trial exploring the efficacy of combining antisecretory agents with antiproteases would be of great benefit in patients with severe AP.

Publication types

  • Meta-Analysis

MeSH terms

  • Acute Disease
  • Anticoagulants / therapeutic use*
  • Clinical Trials as Topic
  • Gabexate / therapeutic use*
  • Hormone Antagonists / therapeutic use*
  • Hormones / therapeutic use*
  • Humans
  • Octreotide / therapeutic use*
  • Pancreatitis / drug therapy*
  • Somatostatin / therapeutic use*
  • Statistics as Topic
  • Treatment Outcome


  • Anticoagulants
  • Hormone Antagonists
  • Hormones
  • Gabexate
  • Somatostatin
  • Octreotide