007 Secretin and autism: A two part clinical investigation

Chez, Michael G.; Buchanan, Cathleen P.; Bagan, Bradley; Hammer, Michael S.; McCarthy, Karla Shockley; Ovrutskaya, Irina; Nowinski, Caralynn V.; Cohen, Zamia S.

doi:10.1016/s1090-3798(99)91356-9

Cited by 23 publications

(37 citation statements)

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“…176 This and other more recent studies have failed to demonstrate any scientific evidence to justify the use of secretin infusion to treat children with ASD. 177,178 • Chelation therapy. Most recently, some concerns have been raised that ASD might be caused by early childhood exposure to environmental toxicants, particularly metals and minerals.…”

Section: Specific Strategiesmentioning

confidence: 99%

Technical Report: The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children

2001

Pediatrics

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ABSTRACT. Autism and its milder variants are not rare. Most pediatricians will have the opportunity to provide a medical home for a child with autism. This technical report serves to complement and expand on the information in the accompanying policy statement to increase the pediatrician's fund of knowledge and comfort level in caring for children with autism. In so doing, it is anticipated that earlier diagnosis and referral for appropriate intervention will be possible and that this will, in turn, have a positive effect on long-term outcomes for children with autism and their families. Pediatrics 2001;107(5). URL: http://www.pediatrics.org/ cgi/content/full/107/5/e85; autism, autistic spectrum disorder, pervasive developmental disorder.

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Section: Specific Strategiesmentioning

confidence: 99%

Technical Report: The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children

2001

Pediatrics

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“…Many of the studies highlighted different dimensions to the question and addressed previous criticisms: nine studies used porcine secretin (3)(4)(5)(6)(7)(11)(12)(13)15), five examined the human synthetic form (2,8,9,14,15), nine studies used cross-over designs (3,5,(7)(8)(9)(10)(11)14,15), and multiple doses were given in two studies (12,14). Several studies examined possible subgroup responders; patients with gastrointestinal symptoms (5)(6)(7)9,12,15), different degrees of autism severity (7,8,12,13,15), and those for whom other medical therapies were allowed (3,6,8,(10)(11)(12) or excluded (15).…”

mentioning

confidence: 99%

“…Several studies examined possible subgroup responders; patients with gastrointestinal symptoms (5)(6)(7)9,12,15), different degrees of autism severity (7,8,12,13,15), and those for whom other medical therapies were allowed (3,6,8,(10)(11)(12) or excluded (15). Secretin doses used were similar to those of the original reports.…”

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confidence: 99%

In children with autism, is intravenous secretin more effective than placebo in improving social skills, communication, behaviour or global functioning?

Goulden

2004

Paediatrics &Amp; Child Health

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“…Recently published placebo-controlled trials [5][6][7] failed to show any effect of secretin on cognitive, language, or behavioral measures, suggesting that secretin is not an effective treatment in autism. It remains possible, however, that these studies may have missed clinically significant changes because of the use of a single injection 5,7 (vs multiple doses), the use of human synthetic 5 rather than porcine secretin, small sample sizes, 6,7 the use of measures that may not be sensitive to drug effects, 6 and the failure to consider possible subgroups of responders, notably those with GI symptomatology.…”

mentioning

confidence: 99%

“…It remains possible, however, that these studies may have missed clinically significant changes because of the use of a single injection 5,7 (vs multiple doses), the use of human synthetic 5 rather than porcine secretin, small sample sizes, 6,7 the use of measures that may not be sensitive to drug effects, 6 and the failure to consider possible subgroups of responders, notably those with GI symptomatology. To address these possibilities, the current study investigated the effect of 2 doses of porcine secretin in 64 children 2 to 7 years of age with autism.…”

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confidence: 99%

Repeated Doses of Porcine Secretin in the Treatment of Autism: A Randomized, Placebo-Controlled Trial

et al. 2001

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ABSTRACT. Background and Objectives. Anecdotal reports on the efficacy of secretin in autism raised great hopes for the treatment of children with this disorder. Initial single-dose, randomized, controlled trials failed to demonstrate any therapeutic effects of secretin. The present study is the first to test the outcome of repeated doses and to examine whether there is a subgroup of children who are more likely to achieve positive effects.Method. Sixty-four children with autism (ages 2-7 years; 55 boys and 9 girls) with a range of intelligence quotient and verbal ability were randomly assigned, in a double-blind manner, to secretin or placebo groups. Children received 2 doses of placebo or porcine secretin, 6 weeks apart. Assessments were performed at baseline and 3 weeks after each injection using several outcome measures.Results. There were no group differences on formal measures of language, cognition, or autistic symptomatology. Subgroupings based on cognitive level, the presence or absence of diarrhea, or a history of regression failed to show any significant therapeutic effects of secretin.Conclusion. No evidence is provided for the efficacy of repeated doses of porcine secretin in the treatment of children with autism. The possible relationship between relief of biological symptoms and enhanced skill performance is discussed. Pediatrics 2001;107(5). URL: http://www.pediatrics.org/cgi/content/full/107/5/ e71; autism, secretin, language, behavior, cognitive functioning, gastrointestinal abnormalities.ABBREVIATIONS. GI, gastrointestinal; HSC, Hospital for Sick Children; ADI-R, Autism Diagnostic Interview-Revised; ADOS-G, Autism Diagnostic Observation Scale-Generic; PLS-3, Preschool Language Scale, III; ABC, Autism Behavior Checklist; ANOVA, analysis of variance.A utism is a severe, life-long neurobiological disorder with high morbidity. The disorder affects virtually all areas of functioning, notably social, communicative, cognitive, and behavioral. Prevalence is estimated to be as high as 5/1000 for the full spectrum of autistic disorders 1 and prognosis is generally poor. 2,3 To date, the cause of autism remains unknown, and there is no specific medical treatment. Psychopharmacological management continues to be far from satisfactory, with no pharmacologic agent having been shown to alter the natural history of the disorder.Against this background, recent clinical reports of a positive response to secretin in children with autism have generated widespread interest in and demand for this hormone. In 1998, Horvath et al 4 reported an uncontrolled case series of 3 autistic children who showed marked improvements in their social and language skills after administration of secretin for an investigative gastrointestinal (GI) procedure. This report received considerable media attention and escalating claims of a potential cure for autism resulted in likely thousands of children with autism being given secretin injections.Recently published placebo-controlled trials 5-7 failed to show any effect of secretin on co...

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007 Secretin and autism: A two part clinical investigation

Cited by 23 publications

References 0 publications

Technical Report: The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children

Technical Report: The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children

In children with autism, is intravenous secretin more effective than placebo in improving social skills, communication, behaviour or global functioning?

Repeated Doses of Porcine Secretin in the Treatment of Autism: A Randomized, Placebo-Controlled Trial

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