Efficacy of the Long-Acting Repeatable Formulation of the Somatostatin Analogue Octreotide in Postoperative Dumping
Abstract
Background & aims Several studies have established symptomatic and mechanistic benefits of the somatostatin analogue octreotide in patients with dumping syndrome, but clinical use is hampered by the requirement for subcutaneous administration 3 times daily. We compared the efficacy of subcutaneous octreotide with that of the long-acting repeatable (LAR) octreotide formulation, which is administered monthly, in patients with dumping syndrome. Methods The study included 30 consecutive patients with postoperative dumping, evidenced by oral glucose tolerance test (OGTT) results and insufficient response to dietary measures. OGTT, dumping severity score (summary of scores 0-3 for 8 early and 6 late dumping symptoms), and quality-of-life data were evaluated at baseline, after 3 days of subcutaneous administration of octreotide (0.5 mg), and then after 3 monthly intramuscular injections of octreotide LAR (20 mg). Results Both formulations of octreotide significantly reduced total dumping severity scores (21.7 +/- 1.6 at baseline, 11.2 +/- 1.2 for subcutaneous and 14.0 +/- 1.8 for LAR formulations; P Conclusions Monthly administration of LAR octreotide improves OGTT results, symptoms, and quality of life in patients with postoperative dumping.
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In severe cases, dumping syndrome is associated with a substantial reduction in quality of life and significant weight loss as a result of avoidance of food intake.
“In severe cases, dumping syndrome is associated with a substantial reduction in quality of life and significant weight loss as a result of avoidance of food intake (15).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [15]
Gastric emptying studies generally have low sensitivity and specificity, probably because the process of rapid gastric emptying occurs soon after ingestion, a phase that is not adequately assessed in most studies.
“However, gastric emptying studies generally have low sensitivity and specificity, probably because the process of rapid gastric emptying occurs soon after ingestion, a phase that is not adequately assessed in most studies.”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [15]
Arts et al. developed a dumping-severity score in which symptoms of early and late dumping (eight and six symptoms, respectively) were scored on a 4-point Likert scale.
“Arts et al. developed a dumping-severity score in which symptoms of early and late dumping (eight and six symptoms, respectively) were scored on a 4-point Likert scale (15).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [15]
The duration of the entire gastric emptying study of up to 4 h is integrated into a single value (half emptying time), which may neutralize the rapid initial emptying effect.
“Furthermore, the duration of the entire study of up to 4 h is integrated into a single value (half emptying time), which may neutralize the rapid initial emptying effect (3,15,37).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [15]
Short-acting formulations may be more effective at improving some dumping symptoms such as hypoglycemia.
“Short-acting formulations may be more effective at improving some dumping symptoms such as hypoglycemia (15,(81)(82)(83)85); however, the need for repeated injections throughout the day is often a major limitation to the long-term administration of short-acting”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [15]
Both short-acting and long-acting formulations of somatostatin analogues have demonstrated efficacy by slowing gastric emptying, improving hypoglycemia and reducing early and late dumping symptoms.
“Both short-acting and long-acting formulations of somatostatin analogues have demonstrated efficacy by slowing gastric emptying, improving hypoglycemia and reducing early and late dumping symptoms (Table 4) (15,66,(80)(81)(82)(83)(84)(85)(86)(87)(88)(89)(90)(91)(92)(93)(94)(95).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [15]
Somatostatin analogues target various steps in the pathophysiology of dumping syndrome, including delaying gastric emptying, delaying transit through the small intestine, inhibiting the release of GI hormones, inhibiting insulin secretion and inhibiting postprandial vasodilation.
“Somatostatin analogues target various steps in the pathophysiology of dumping syndrome, including delaying gastric emptying, delaying transit through the small intestine, inhibiting the release of GI hormones, inhibiting insulin secretion and inhibiting postprandial vasodilation (15,(67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77)(78).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [15]
Long-acting somatostatin analogue formulations are preferred by patients over short-acting formulations because of less frequent administration and associated improvements in quality of life.
“Long-acting formulations are preferred by patients because of less frequent administration and the associated improvements in quality of life (15,89).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [15]
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Self-citation
- Authors
- Arts, J., Caenepeel, P., Bisschops, R., Dewulf, D., Holvoet, L., Piessevaux, H., Bourgeois, S., Sifrim, D., Janssens, J., & Tack, J.
- Affiliations
- Universitair Ziekenhuis Leuven (BE)
- Cliniques Universitaires Saint-Luc (BE)
- Ziekenhuisnetwerk Antwerpen Stuivenberg (BE)
- Corresponding author
- Tack, Jan
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2009-04
- Volume
- 7
- Issue
- 4
- Pages
- 432-437
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W2095380880
- Cited by
- 142
- References
- 43
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 15 · 2023: 15 · 2022: 13 · 2021: 9 · 2020: 11 · 2019: 14 · 2018: 8 · 2017: 5 · 2016: 5 · 2015: 8 · 2014: 3 · 2013: 3 · 2012: 4
- FWCI
- 3.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- DIAL (Catholic University of Leuven) (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- octreotide, somatostatin analogues, subcutaneous administration, intramuscular injection, oral glucose tolerance test, quality of life, gallstones, postgastrectomy complications
- MeSH terms
- Adult, Belgium, Delayed-Action Preparations, Dumping Syndrome, Female, Gastrointestinal Agents, Glucose Tolerance Test, Humans, Male, Quality of Life, Severity of Illness Index, Octreotide, Treatment Outcome
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