Octreotide in patients with active ulcerative colitis treated with high dose corticosteroids (OPUS 1)
Research output: Contribution to journal › Journal article › Research › peer-review
BACKGROUND: In ulcerative colitis the intestinal somatostatin content is reduced. Somatostatin has several immune-inhibitory effects. In vitro it diminishes activity of intestinal lymphocytes and peripheral blood monocytes. Its long-acting analogue octreotide has beneficial effects on mucosal damage in acute experimental acetic acid colitis in rats.
AIMS: To determine the potential benefits of octreotide as a treatment for patients with severe ulcerative colitis treated with high dose corticosteroids.
PATIENTS: Forty-two patients with severe ulcerative colitis (more than 10 points on the Powell-Tuck scoring system and mucosal disease Heatly grade III or IV).
METHODS: In a multi-centre, double blind, placebo-controlled trial all patients were treated with oral 5-ASA (1.6-2.4 g daily) and high dose corticosteroids (tapering off from 60 to 80 mg daily). They were randomly assigned to receive subcutaneous placebo (n = 22) or octreotide 500 microg (n = 20) thrice daily during 21 days. Clinical and endoscopic disease activity, histology and laboratory parameters were obtained during the study period.
RESULTS: Clinical disease activity for both octreotide and placebo were not significantly different at baseline and after 21 days of treatment. Endoscopic disease activities (mean +/- SD) changed from 12.5 +/- 4.7 to 7.2 +/- 5.3 for octreotide, and from 11.5 +/- 5.0 to 5.0 +/- 3.4 for placebo (NS). Seven patients from both groups received additional treatment (colectomy (n = 6), cyclosporin (n = 1)). Adverse events occurred equally in both groups.
CONCLUSIONS: Subcutaneous administration of octreotide 500 microg thrice daily is not of additional benefit as adjuvant therapy to high dose corticosteroids in severe ulcerative colitis.
|Journal||European journal of gastroenterology & hepatology|
|Number of pages||6|
|Publication status||Published - Mar 2002|
- Adult, Anti-Inflammatory Agents, Non-Steroidal/therapeutic use, Colitis, Ulcerative/drug therapy, Double-Blind Method, Drug Administration Schedule, Female, Gastrointestinal Agents/therapeutic use, Glucocorticoids/administration & dosage, Humans, Male, Mesalamine/therapeutic use, Octreotide/administration & dosage, Prednisolone/administration & dosage, Prednisone/administration & dosage, Severity of Illness Index