Octreotide for gastrointestinal bleeding in hereditary hemorrhagic telangiectasia: A prospective case series

Kroon, Steven; Snijder, Repke J.; Mager, Johannes J.; Post, Martijn C.; Noorden, Jacco Tenthof van; Geenen, Erwin J M van; Drenth, Joost P.H.; Grooteman, Karina V.

doi:10.1002/ajh.25563

Cited by 11 publications

(18 citation statements)

References 8 publications

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“…This agent has shown a reduction in digestive bleeding and an anemia improvement in non-HHT patients with intestinal angiodysplasia by reducing splanchnic blood flow, but evidence of its use in HHT patients is scarce [33][34][35][36]. A non-randomized prospective clinical trial to assess the efficacy of monthly injection of 20 mg of octreotide LAR has been recently published [36]. Although this study was underpowered (beta of 0.5), RBC transfusion requirements were lower during the six months treatment period than they were prior to treatment, in all 11 patients included.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Bleeding in Patients with Hereditary Hemorrhagic Telangiectasia: Risk Factors and Endoscopic Findings

Mora-Luján

Iriarte

Alba

et al. 2019

JCM

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Background: We aimed to describe risk factors for gastrointestinal (GI) bleeding and endoscopic findings in patients with hereditary hemorrhagic telangiectasia (HHT). Methods: This is a prospective study from a referral HHT unit. Endoscopic tests were performed when there was suspicion of GI bleeding, and patients were divided as follows: with, without, and with unsuspected GI involvement. Results: 67 (27.9%) patients with, 28 (11.7%) patients without, and 145 (60.4%) with unsuspected GI involvement were included. Age, tobacco use, endoglin (ENG) mutation, and hemoglobin were associated with GI involvement. Telangiectases were mostly in the stomach and duodenum, but 18.5% of patients with normal esophagogastroduodenoscopy (EGD) had GI involvement in video capsule endoscopy (VCE). Telangiectases ≤ 3 mm and ≤10 per location were most common. Among patients with GI disease, those with hemoglobin < 8 g/dL or transfusion requirements (65.7%) were older and had higher epistaxis severity score (ESS) and larger telangiectases (>3 mm). After a mean follow-up of 34.2 months, patients with GI involvement required more transfusions and more emergency department and hospital admissions, with no differences in mortality. Conclusions: Risk factors for GI involvement have been identified. Patients with GI involvement and severe anemia had larger telangiectases and higher ESS. VCE should be considered in patients with suspicion of GI bleeding, even if EGD is normal. Author Contributions: Conceptualization: J.M.M.-L. and A.R.-M.; data curation: J.M.M.-L., A.I., A.B., P.C. and A.R.-M.; formal analysis: J.M.M.-L., A.I., P.C. and A.R.-M.; investigation: J.M.Mmethodology: J.M.M.-L. and A.R.-M.; supervision: J.R., J.C. and A.R.-M.; validation: J.M.M.-L., A.I., E.A., M.Á.S.-C., A.B., P.C., F.C., J.R., J.C. and A.R.-M.; visualization: J.M.M.-L., E.A., F.C. and A.R.-M.; writing-original draft preparation: J.M.M.-L., A.I., E.A., M.Á.S.-C., A.B., P.C., F.C. and A.R.-M.; writing-review and editing: J.M.M.-L., J.R., J.C. and A.R.-M; funding acquisition: A.R.-M. All authors have read and agreed to the published version of the manuscript.

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Section: Discussionmentioning

confidence: 99%

Gastrointestinal Bleeding in Patients with Hereditary Hemorrhagic Telangiectasia: Risk Factors and Endoscopic Findings

Mora-Luján

Iriarte

Alba

et al. 2019

JCM

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“…Octreotide has been recently shown to be an effective therapy in treating recurrent GI bleeds secondary to telangiectasias in patients with poor responses to traditional therapies. In HHT patients, the role of octreotide is believed to be related to its function as a VEGF inhibitor[ 7 ]. A case report of HHT treated with SQ octreotide described a 74-year-old male who was diagnosed with HHT at age 9[ 6 ].…”

Section: Hhtmentioning

confidence: 99%

“…After he began octreotide treatment, the patient did not require endoscopic interventions for over six month, as compared to needing three interventions the six month prior to starting treatment, and he required his first endoscopic intervention after approximately 13 mo. A prospective case series in 2019 investigated the safety and efficacy of octreotide for GI bleeding in HHT patients[ 7 ]. The trial showed that octreotide-treated patients needed much fewer RBC units for transfusion than the six month prior to treatment[ 7 ].…”

Section: Hhtmentioning

confidence: 99%

“…Additionally, octreotide can be used to manage watery diarrhea in VIP-secreting tumors, and it can reduce growth hormone and insulin-like growth factor concentrations in patients with acromegaly[ 5 ]. Recently, octreotide has been shown to be an effective therapy in treating GI bleeding in patients with poor responses to previous treatments[ 6 , 7 ]. The common adverse effects of octreotide include diarrhea, abdominal pain, flatulence, steatorrhea, vomiting, cholelithiasis, biliary sludge, sinus bradycardia, conduction abnormalities, and arrhythmias[ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Role of octreotide in small bowel bleeding

Khedr¹,

Mahmoud²,

Attallah³

et al. 2022

WJCC

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Gastrointestinal bleeding accounts for a drastic negative impact on the quality of the patients’ lives as it requires multiple diagnostic and therapeutic interventions to identify the source of the bleeding. Small bowel bleeding is the least common cause of gastrointestinal bleeding. However, it is responsible for the majority of complaints from patients with persisting or recurring bleeding where the primary source of bleeding cannot be identified despite investigation. A somatostatin analog known as octreotide is among the medical treatment modalities currently used to manage small bowel bleeding. This medication helps control symptoms of gastrointestinal bleeding by augmenting platelet aggregation, decreasing splanchnic blood flow, and antagonizing angiogenesis. In this review article, we will highlight the clinical efficacy of octreotide in small bowel bleeding and its subsequent effect on morbidity and mortality.

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“…Tab. (12)(13)(14)(15). Dále pak podobně jako u epistaxe antifibrinolytika a antiangiogenní léky (1)(2)(3)(4).…”

Section: úVodunclassified

Hereditary hemorrhagic telangiectasia (Osler‑Weber‑Rendu syndrome) - Part II. Pharmacological therapy and international guidelines for the therapy 2020

Adam¹,

Brančíková²,

Romanová³

et al. 2021

Vnitř Lék

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Octreotide for gastrointestinal bleeding in hereditary hemorrhagic telangiectasia: A prospective case series

Cited by 11 publications

References 8 publications

Gastrointestinal Bleeding in Patients with Hereditary Hemorrhagic Telangiectasia: Risk Factors and Endoscopic Findings

Gastrointestinal Bleeding in Patients with Hereditary Hemorrhagic Telangiectasia: Risk Factors and Endoscopic Findings

Role of octreotide in small bowel bleeding

Hereditary hemorrhagic telangiectasia (Osler‑Weber‑Rendu syndrome) - Part II. Pharmacological therapy and international guidelines for the therapy 2020

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