Eficacia del octreótido sobre la recurrencia hemorrágica de las angiectasias del intestino delgado. Estudio comparativo

Abstract

IntroductionFifty percent of small bowel bleeding is caused by angioectasia and the rebleeding rate due to small bowel angioectasia (SBA) is 80%. Its endoscopic treatment is difficult. Beneficial effects of octreotide on gastrointestinal angioectasia have been described, but no studies have reported its efficacy in SBA. AimOur aim was to investigate the effectiveness of octreotide in the prevention of rebleeding due to SBA. Material and methodsSixteen patients with bleeding caused by SBA were assigned to treatment with octreotide 100μg/24h SC, for at least 6 months, and compared with a non-treatment group of 36 patients. The primary outcome was the rebleeding rate, and the secondary outcomes were the number of hospital readmissions, bleeding-related death, and adverse effects. ResultsOctreotide was administered for 10.5±8.4 months. Follow-up was 12.9±17.3 months and 15.3±17.7 months, in the treatment and non-treatment groups, respectively (p=0.09). At the end of follow-up, 4 (25%) treatment group patients and 26 (72.2%) non-treatment group patients presented with rebleeding (p=0.002). In the treatment group and non-treatment group, the cumulative probability of remaining rebleeding-free at one year was 79% vs 44.2%, and 79% vs 34.6% at 2 years, respectively (p=0.05). Through the multiple logistic regression analysis, treatment was the protective variable. Six patients presented with adverse events. One of those patients (6.25%) had a major adverse event. ConclusionsOur results suggest that treatment with octreotide could be efficacious in the prevention of rebleeding due to SBA.