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Octreotide therapy beats standard of care in GIADs

Presented By
Ms Lia Goltstein, Radboud University Medical Center, the Netherlands
Presented by
Lia Goltstein Radboud University Medical Center
DDW 2022
The somatostatin analogue octreotide was investigated for the treatment of gastrointestinal angiodysplasias (GIADS) with anaemia. The results showed that therapy with octreotide led to a marked reduction of transfusions and the necessity of rescue treatment.

“GIADs are vascular malformations that frequently cause patients to suffer from symptomatic disease, ranging from mild anaemia to severe red blood cell transfusion dependency,” explained Ms Lia Goltstein (Radboud University Medical Center, the Netherlands), who presented a trial that compared octreotide in GIAD treatment with standard of care (SoC) [1].

The study recruited 62 Dutch patients between 2015 and 2021. A prerequisite for inclusion was a need for ≥4 transfusions of either red blood cells with or without 500 mg of iron intravenous in the year before the study. The 2 study groups received either 40 mg of intramuscular octreotide every 28 days or SoC. The primary endpoint was defined as the mean difference in the number of transfusion units among the groups. Throughout the study, endoscopic therapy was possible as a means of rescue treatment. The extent of these rescue endoscopies in the study groups was a secondary endpoint.

Mean baseline frequency data for patient requirements throughout the year before the trial was 20.3 for transfusion units and 2.4 for endoscopic treatments. Over the study period of 1 year, octreotide treatment led to a significant reduction in transfusions compared with SoC: 11.0 (95% CI 5.5–16.5) versus 21.2 (95% CI 15.7–26.7; P=0.011). Furthermore, endoscopic interventions were significantly decreased in the octreotide-treated study cohort (P=0.005).

The authors expressed that octreotide treatment effectively reduced the transfusion requirements and endoscopic procedures of patients with GIAD-related anaemia. These findings may be complemented by a result from an also presented meta-analysis of individual patient data on somatostatin analogues in GIADs, which demonstrated that patients with GIADs in the small intestine or colon have the greatest benefit from octreotide [2].

  1. Goltstein L. Octreotide significantly reduces transfusion requirements compared to standard care in patients with angiodysplasia-related anemia: a multicenter randomized controlled trial. Lecture 876d, Digestive Disease Week 2022, 21–24 May, San Diego, CA, USA.

  2. Goltstein L, et al. Somatostatin analogs are highly effective and safe in patients with gastrointestinal angiodysplasias: An individual patient data meta-analysis. Abstract Sa109, Digestive Disease Week 2022, 21–24 May, San Diego, CA, USA.

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