Table 9.

Summary table of studies of somatostatin analogues in late dumping syndrome or PBH.

Study	Population	Intervention	Comparator	Outcome
Arts, 2009 (116)	Upper GI surgery including partial gastrectomy, RYGB, Nissen fundoplication, partial oesophagectomy; post-operative hypoglycaemia (<3.3 mmol/L) during OGTT, n = 30 n = 10 had had RYGB	SC Octreotide 50 µg three times a day for 3 days (cross-over study)	IM Octreotide LAR 20 mg monthly for 3 months	SC octreotide improved nadir glucose during OGTT although 7/30 still experienced significant hypoglycaemia. IM octreotide LAR (3 months’ treatment) improved nadir glucose during OGTT although 11/30 still experienced significant hypoglycaemia. Improvements in late dumping severity scores with both SC octreotide and IM octreotide LAR.
Tack, 2018 (117)	Upper GI surgery including RYGB, gastrectomy, oesophagectomy; symptomatic hypoglycaemia (late dumping symptoms), n = 43 for SC dose escalation phase (38 with RYGB). Only n = 33 (28 with RYGB) went on to IM phase	3-month dose escalation phase with SC pasireotide (50−200 µg three times a day) followed by 3-month IM phase (10 or 20 mg monthly), and optional 6-month extension phase with IM pasireotide	None (single-arm trial)	60.5% of people did not have hypoglycaemia at end of SC phase. 36.4% of people did not have hypoglycaemia at end of IM phase.
Wauters, 2019 (118)	Upper GI surgery: gastrectomy/bypass, oesophagectomy, non-resective oesophageal surgery; meeting criteria for early dumping syndrome, or late dumping syndrome (hypoglycaemia <60 mg/dL or 3.3 mmol/L) during OGTT, or history of hypoglycaemia <60 mg/dL or 3.3 mmol/L; n = 24 (2 arms of 12)	SC lanreotide Autogel 90 mg monthly over 3 months Double-blind, randomised, placebo-controlled crossover study where all people underwent 3 months of lanreotide and 3 months of placebo	Saline injection monthly over 3 months	Lanreotide improved early dumping symptom score but not late dumping symptom score (hypoglycaemia).
Whyte, 2010 (121)	Symptomatic RYGB, n = 4	Single dose of SC octreotide 100 µg	No treatment	Symptomatic hypoglycaemia during extended OGTT said to have been prevented by pre-treatment with octreotide.
de Heide, 2014 (120)	Symptomatic RYGB, n = 1	Single dose of SC octreotide 100 µg	Single dose of SC pasireotide 300 µg	Octreotide given prior to MMT resulted in hypoglycaemia (2.0 mmol/L) during MMT whereas pasireotide did not (3.5 mmol/L). SC Pasireotide 300 µg twice a day resulted in amelioration of hypoglycaemic episodes.
Ohrstrom, 2019 (99)	Symptomatic RYGB, n = 11	Single dose of SC pasireotide 300 µg prior to MMT	Compared to no-treatment baseline (part of cross-over study with sitagliptin, verapamil, liraglutide, acarbose)	Significant increases in nadir glucose during MMT.

CGM, continuous glucose monitoring; IM, intramuscular; IV, intravenous; LAR, long-acting release; MMT, mixed meal test; OGTT, oral glucose tolerance test; RYGB, Roux-en-Y gastric bypass; SC, subcutaneous.