Efficacy of Somatostatin and Vasopressin in the Control of Acute Variceal Hemorrhage

Jenkins, S. A.; Baxter, J. N.; Corbett, W. A.; Devitt, P.; Ware, James H.; Shields, R.; Kravetz, David; Terés, J; Bosch, Jaume; Bruix, Jordi; Rodés, Joan

doi:10.1002/hep.1840050239

Cited by 14 publications

(3 citation statements)

References 3 publications

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“…Although terlipressin, a synthetic analogue of vasopressin, and somatostatin are effective in controlling bleeding, they are not available in the United States. 102,103 A combination of endoscopic treatment (usually EVL) and pharmacologic treatment (octreotide in the United States) is the preferred first-line treatment to achieve hemostasis 89,104 -106 (Figure 5).…”

Section: Control Of Bleedingmentioning

confidence: 99%

Portal Hypertension and Its Complications

et al. 2008

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Section: Control Of Bleedingmentioning

confidence: 99%

Portal Hypertension and Its Complications

et al. 2008

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“…The importance of a meticulous administration of the peptide because of its short half-life has been pointed out by Jenkins et al (30) In Ten patients were given somatostatin and in all of them initial haemostatis was achieved. Before sclerotherapy, 3 patients rebled, but these rebleedings were successfully treated by somatostatin.…”

Section: Clinical Studiesmentioning

confidence: 98%

Secretin and Somatostatin in the Treatment of Upper Gastrointestinal Haemorrhage

Magnusson¹

1987

Scandinavian Journal of Gastroenterology

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Magnusson I . Secretin and somatostatin in the treatment of upper gastrointestinal haemorrhage. Scand J Gastroenterol 1987, 22(suppl 137), 56-60Secretin inhibits gastric secretion of acid and gastrin in dog and a physiological role of sccretin as an enterogastrone has been suggested in this species. In man there are diverging results concerning the effect of secretin on gastric secretion. Secretin has been used in patients with upper gastrointestinal bleeding and po been reported, but the patients included in these studies cannot he considered as massive bleeders. Until now no double-blind study comparing secretin with placebo has been reported. Somatostatin decreases splanchnic blood flow and gastric secretion in man. Somatostatin seems to be effective in achieving initial haemostasis in patients with bleeding oesophageal varices. The pcptide has also been shown to stop severe and persistent peptic ulcer haemorrhage and to stop bleeding in patients treated with steroidal and non-steroidal anti-inflammatory drugs. In one double-blind trial in patients with upper gastrointestinal bleeding, somatostatin had no et'fect on either thc number of emergency operations or the number of rcbleedings. In another double blind study, when somatostatin was compared with placebo in patients with massive upper gastrointestinal bleeding, the peptide reduced the number of emergency operations. In conclusion. most studies show positive effects of somatostatin on variceal and peptic ulcer haemorrhage. SwedenScand J Gastroenterol Downloaded from informahealthcare.com by Indiana University on 12/13/14For personal use only.34. Coraggio F, Scarpato P, Spina M, Lombardi S. Br Med J 1984, 289, 224 Scand J Gastroenterol Downloaded from informahealthcare.com by Indiana University on 12/13/14For personal use only.

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“…Bleeding control. Twenty-one RCTs [7,9,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] including 2,431 patients were included in this meta-analysis. The probability of bleeding control was similar between the T-V and O-S groups (RR: 0.96; 95%CI: 0.91-1.02; I 2 =53%).…”

Section: Meta-analysis Of Outcomesmentioning

confidence: 99%

Vasoactive Agents for the Management of Acute Variceal Bleeding: A Systematic Review and Meta-analysis

Huaringa-Marcelo

Huaman

Brañez-Condorena

et al. 2021

JGLD

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Background and Aims: Vasoactive agents with endoscopic therapy are used to treat acute variceal bleeding (AVB). There are two main groups of vasoactive agents: terlipressin and vasopressin (T-V), and octreotide and somatostatin (O-S). However, the benefit/harm balance is unclear. Our aim was to assess the efficacy and safety of T-V versus O-S for the management of AVB. Methods: We performed a systematic search for randomized controlled trials (RCTs) in PubMed, Scopus, and CENTRAL. Our main outcomes were mortality and adverse events. Secondary outcomes were bleeding control, rebleeding, blood transfusion, hospital stay. We evaluated the certainty of evidence using GRADE methodology. Results: We included 21 RCTs. The risk of mortality (RR: 1.01; 95%CI: 0.83-1.22), bleeding control (RR: 0.96; 95%CI: 0.91-1.02; I 2 =53%), early rebleeding (RR: 0.91; 95%CI: 0.66-1.24: I 2 =0%), late rebleeding (RR: 0.94; 95 CI: 0.56-1.60; I 2 =0%), blood transfusion (MD: 0.04; 95%CI: -0.31-0.39; I 2 =68%) and hospital stay (MD: -1.06; 95%CI: -2.80-0.69; I 2 =0%) were similar between T-V and O-S groups. Only 15 studies reported adverse events, which were significantly higher in the T-V compared to the O-S group (RR 2.39; 95%CI: 1.58-3.63; I 2 =57%). The certainty of evidence was moderate for the main outcomes, and low or very low for others. Conclusions: In cirrhotic patients with AVB, those treated with T-V had similar mortality risk compared to O-S. However, the use of T-V showed an increased risk of adverse events compared to O-S.

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Efficacy of Somatostatin and Vasopressin in the Control of Acute Variceal Hemorrhage

Cited by 14 publications

References 3 publications

Portal Hypertension and Its Complications

Portal Hypertension and Its Complications

Secretin and Somatostatin in the Treatment of Upper Gastrointestinal Haemorrhage

Vasoactive Agents for the Management of Acute Variceal Bleeding: A Systematic Review and Meta-analysis

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