A Systematic Review of Secretin for Children With Autism Spectrum Disorders

Krishnaswami, Shanthi; McPheeters, Melissa L; Veenstra‐VanderWeele, Jeremy

doi:10.1542/peds.2011-0428

Cited by 52 publications

(18 citation statements)

References 17 publications

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“…Intravenous secretin and vision therapy were the least used among CAM treatments, perhaps because these interventions have been formally studied and established to be ineffective. [10][11][12] These preferences suggest that parents can make more informed choices and decisions when adequate scientific data are made available. In the current study, parental desire for information was reflected in their interest in research pertaining to CAM treatments, with more than 90% of the parents of children with ADHD and ASD wanting to see more research.…”

Section: Discussionmentioning

confidence: 99%

Parental Perspectives on Use, Benefits, and Physician Knowledge of Complementary and Alternative Medicine in Children with Autistic Disorder and Attention-Deficit/Hyperactivity Disorder

Huang

Seshadri²,

Matthews³

et al. 2013

The Journal of Alternative and Complementary Medicine

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Background: Complementary and alternative medicine (CAM) use appears to be increasing in children with developmental disorders. However, it is not clear whether parents perceive their healthcare providers as resources who are knowledgeable about CAM therapies and are interested in further developing their knowledge. Objectives: (1) To establish and compare use of, and perceived satisfaction with, traditional medicine and CAM in children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs) and (2) to assess parental perceptions of physician knowledge of CAM and physician interest in continuing education about CAM for the two groups of parents. Methods: Families of children with a diagnosis of ADHD or ASD were surveyed regarding the frequency of use of traditional treatment and CAM, parental perceptions of the helpfulness of each therapy, parental perceptions regarding physicians' knowledge level about CAM, and physician interest in continuing education. Results: Thirty-six percent (n = 135) of 378 surveys were returned: 41 contained a diagnosis of ADHD and 22 of ASD. Traditional therapies were used by 98% of children with ADHD and 100% of those with ASD. Perceived helpfulness of medication was 92% for children with ADHD and 60% for children with ASD ( p < 0.05). CAM was used for 19.5% of children with ADHD and 82% of children with ASD. Perceived satisfaction for any form of CAM in the children with ADHD was at an individual patient level. Satisfaction for two of the most commonly used CAM treatments in children with ASD ranged from 50% to 78%. In children with ASD (the diagnostic group with the highest use of and satisfaction with CAM), physician's perceived knowledge of CAM was lower (14% versus 38%; p < 0.05), as was perceptions of the physician's interest in learning more ( p < 0.05). Conclusion: CAM use is significant, especially in children with ASD. Physicians are not perceived as a knowledgeable resource.

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Section: Discussionmentioning

confidence: 99%

Parental Perspectives on Use, Benefits, and Physician Knowledge of Complementary and Alternative Medicine in Children with Autistic Disorder and Attention-Deficit/Hyperactivity Disorder

Huang

Seshadri²,

Matthews³

et al. 2013

The Journal of Alternative and Complementary Medicine

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“…From the experience that followed, including some 15 controlled trials and more than 600 participants, 4,5 it could be argued that treatment with secretin was associated with an improvement in a significant percentage of participants. However, the placebo condition uniformly delivered equal or better outcomes across all of these trials, and the sum of the evidence is that there is no therapeutic signal for secretin in autism.…”

mentioning

confidence: 99%

“…However, the placebo condition uniformly delivered equal or better outcomes across all of these trials, and the sum of the evidence is that there is no therapeutic signal for secretin in autism. 4,5 And although neither autism nor the symptom targets that have been the focus of clinical trials would seem particularly likely to be placebo responsive, it is clear that improvement is to be expected in many children and adolescents with autism who enter these studies.…”

mentioning

confidence: 99%

Baseline Factors Predicting Placebo Response to Treatment in Children and Adolescents With Autism Spectrum Disorders

et al. 2013

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IMPORTANCE The finding of factors that differentially predict the likelihood of response to placebo over that of an active drug could have a significant impact on study design in this population. OBJECTIVE To identify possible nonspecific, baseline predictors of response to intervention in a large randomized clinical trial of children and adolescents with autism spectrum disorders. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of citalopram hydrobromide for children and adolescents with autism spectrum disorders and prominent repetitive behavior. Baseline data at study entry were examined with respect to final outcome to determine if response predictors could be identified. A total of 149 children and adolescents 5 to 17 years of age (mean [SD] age, 9.4 [3.1] years) from 6 academic centers were randomly assigned to citalopram (n = 73) or placebo (n = 76). Participants had autistic disorder, Asperger syndrome, or pervasive developmental disorder, not otherwise specified; had illness severity ratings that were moderate or more than moderate on the Clinical Global Impression–Severity scale; and scored moderate or more than moderate on compulsive behaviors measured with the modified Children’s Yale-Brown Obsessive-Compulsive Scale. INTERVENTIONS Twelve weeks of treatment with citalopram (10 mg/5 mL) or placebo. The mean (SD) maximum dose of citalopram was 16.5 (6.5) mg by mouth daily (maximum dose, 20 mg/d). MAIN OUTCOMES AND MEASURES A positive response was defined as having a score of at least much improved on the Clinical Global Impression–Improvement scale at week 12. Baseline measures included demographic (sex, age, weight, and pubertal status), clinical, and family measures. Clinical variables included baseline illness severity ratings (the Aberrant Behavior Checklist, the Child and Adolescent Symptom Inventory, the Vineland Adaptive Behavior Scales, the Repetitive Behavior Scale–Revised, and the Children’s Yale-Brown Obsessive-Compulsive Scale). Family measures included the Caregiver Strain Questionnaire. RESULTS Several baseline predictors of response were identified, and a principal component analysis yielded 3 composite measures (disruptive behavior, autism/mood, and caregiver strain) that significantly predicted response at week 12. Specifically, participants in the placebo group were significantly less likely than participants in the citalopram group to respond at week 12 if they entered the study more symptomatic on each of the 3 composite measures, and they were at least 2 times less likely to be responders. CONCLUSIONS AND RELEVANCE This analysis suggests strategies that may be useful in anticipating and potentially mitigating the nonspecific response in randomized clinical trials of children and adolescents with autism spectrum disorders. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00086645

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“…Replicated studies, however, had no significant effects (27) or only marginal improvements on some individuals (28–30), thereby rejecting SCT as an effective treatment against ASD (31). Although clinical studies did not get satisfactory results, animal experiments did reveal the role of SCT in social behaviors.…”

Section: Sct In Hippocampus Controls Social Behavior and Spatial Learmentioning

confidence: 99%

The Central Mechanisms of Secretin in Regulating Multiple Behaviors

Zhang

Chow

2014

Front. Endocrinol.

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Secretin (SCT) was firstly discovered as a gut peptide hormone in stimulating pancreatic secretion, while its novel neuropeptide role has drawn substantial research interests in recent years. SCT and its receptor (SCTR) are widely expressed in different brain regions, where they exert multiple cellular functions including neurotransmission, gene expression regulation, neurogenesis, and neural protection. As all these neural functions ultimately can affect behaviors, it is hypothesized that SCT controls multiple behavioral paradigms. Current findings support this hypothesis as SCT–SCTR axis participates in modulating social interaction, spatial learning, water and food intake, motor coordination, and motor learning behaviors. This mini-review focuses on various aspects of SCT and SCTR in hippocampus, hypothalamus, and cerebellum including distribution profiles, cellular functions, and behavioral phenotypes to elucidate the link between cellular mechanisms and behavioral control.

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A Systematic Review of Secretin for Children With Autism Spectrum Disorders

Cited by 52 publications

References 17 publications

Parental Perspectives on Use, Benefits, and Physician Knowledge of Complementary and Alternative Medicine in Children with Autistic Disorder and Attention-Deficit/Hyperactivity Disorder

Parental Perspectives on Use, Benefits, and Physician Knowledge of Complementary and Alternative Medicine in Children with Autistic Disorder and Attention-Deficit/Hyperactivity Disorder

Baseline Factors Predicting Placebo Response to Treatment in Children and Adolescents With Autism Spectrum Disorders

The Central Mechanisms of Secretin in Regulating Multiple Behaviors

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