Table 4.
Summary of studies evaluating somatostatin analogues in dumping syndrome
| Study | n | Treatment | Result |
|---|---|---|---|
| Short-acting somatostatin analogues | |||
| Hopman et al.122 | 12 | Octreotide 50 µg versus placebo prior to OGTT | Improved symptoms of dumping syndrome and suppression of postprandial rise in pulse rate; reduced peak insulin and higher nadir glycaemia; slowing of gastrointestinal transit |
| Primrose and Johnston125 | 10 | Octreotide 50 µg versus 100 µg versus placebo prior to OGTT | Reduced symptoms of early dumping syndrome and abolished symptoms of late dumping syndrome; suppression of early dumping-associated changes in haematocrit and pulse rate; inhibition of hypoglycaemia |
| Tulassay et al.127 | 8 | Octreotide 50 µg versus placebo prior to OGTT | Suppression of rise in pulse rate and haematocrit; suppression of rise in plasma levels of vasoactive intestinal polypeptide; inhibition of postprandial hypoglycaemia; inhibition of rise in plasma levels of insulin and gastric inhibitory polypeptide |
| Geer et al.128 | 10 | Octreotide 100 µg versus placebo prior to a dumping provocative meal | Prevention of development of symptoms of dumping syndrome and diarrhoea; prevention of late hypoglycaemia and of the rise in plasma levels of glucose, glucagon, pancreatic polypeptide, neurotensin and insulin; delayed gastric emptying and intestinal transit |
| Richards et al.129 | 6 | Octreotide 100 µg versus placebo prior to a dumping provocative meal | Prevention of symptoms of dumping syndrome; induction of migrating motor complex phase 3 in the small intestine; less postprandial intestinal motor activity |
| Gray et al.130 | 9 | Octreotide 100 µg versus placebo prior to a dumping provocative meal | Suppression of rise in pulse rate; inhibition of insulin release; prevention of hypoglycaemia; inhibition of symptoms of dumping syndrome |
| Hasler et al.131 | 8 | Octreotide 50 µg versus placebo prior to OGTT | Suppression of rise in pulse rate; inhibition of symptoms of dumping syndrome and diarrhoea; no influence on change in haematocrit; inhibition of insulin release; prevention of hypoglycaemia; no influence on gastric emptying rate |
| Arts et al.17 | 30 | Octreotide 50 µg prior to OGTT | Suppression of rise in pulse rate and haematocrit; inhibition of postprandial hypoglycaemia; inhibition of rise in plasma levels of insulin; improvement of symptoms of early and late dumping syndrome |
| Deloose et al.68 | 9 | Crossover placebo or pasireotide 300 µg for 2 weeks | Inhibition of postprandial hypoglycaemia; slowed gastric emptying rate |
| Tack et al.86 | 43 | 3-month dose-escalation study with pasireotide 50–200 µg (subcutaneous) followed by extension with monthly long-acting 10 mg or 20 mg injections | Improvement of symptoms of late and early dumping syndrome and signs on the OGTT |
| Long-acting somatostatin analogues | |||
| Arts et al.17 | 30 | Octreotide long-acting release 20 mg (intramuscular) | Suppression of rise in pulse rate and haematocrit; inhibition of postprandial hypoglycaemia; inhibition of rise in plasma levels of insulin; improvement of symptoms of early and late dumping syndrome and quality of life; preferred by patients over short-acting formulation |
| Wauters et al.67 | 24 | Crossover study with placebo or lanreotide 90 mg (intramuscular) | Improvement of symptoms of early but not late dumping syndrome. |
OGTT, modified oral glucose tolerance test.