Long-acting somatostatin analogues decrease blood transfusion requirements in patients with refractory gastrointestinal bleeding associated with angiodysplasia

Aliment Pharmacol Ther. 2012 Sep;36(6):587-93. doi: 10.1111/apt.12000. Epub 2012 Jul 26.

Abstract

Background: Gastrointestinal angiodysplasias (GIADs) may be the cause of recurrent bleeding, despite endoscopic treatment.

Aim: To evaluate the effect of long-acting somatostatin analogues on blood transfusion requirements, in patients with refractory bleeding due to GIADs.

Methods: Consecutive patients with recurrent bleeding from GIADs were enrolled. They received somatostatin analogue treatment for at least 6 months. The efficacy was evaluated in terms of blood transfusions, frequency of bleeding episodes and haemoglobin level during 6 months of treatment (Period During) compared to a 6-months' period before treatment (Period Before).

Results: Fifteen patients were enrolled from 2007 to 2010. The median duration of somatostatin analogue treatment was 12 months (range: 6-36). The number of transfusions significantly decreased in Period During compared with Period Before [median number: 2 (0-14) vs. 10 (6-24); P < 0.001]. The percentage of patients who experienced a bleeding event was lower during somatostatin analogues treatment (20% vs. 73%; P = 0.01). The mean haemoglobin level was significantly higher when somatostatin analogues were offered [median: 10 g/dL (9-13) vs. 7 (5-8.5); P < 0.001]. None of the patients discontinued treatment due to side effects.

Conclusions: Long-acting somatostatin analogues treatment decreased transfusion needs in patients with refractory bleeding from gastrointestinal angiodysplasias. Bleeding episodes were limited and haemoglobin improved during treatment. Long-acting somatostatin analogues may represent an option for the management of patients with chronic bleeding due to gastrointestinal angiodysplasias.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiodysplasia / complications
  • Angiodysplasia / drug therapy*
  • Blood Transfusion*
  • Colonoscopy
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / prevention & control*
  • Gastroscopy
  • Hormones / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Somatostatin / analogs & derivatives
  • Somatostatin / therapeutic use*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Hormones
  • Somatostatin