Summary

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• Sandostatin (octreotide acetate) is indicated to reduce blood levels of growth hormone (GH) and insulin growth factor-1 (IGF-1; somatomedin C) in acromegaly patients who have had inadequate response to or cannot be treated with surgical resection, pituitary irradiation, and bromocriptine mesylate at maximally tolerated doses. It is also used for the symptomatic treatment of patients with metastatic carcinoid tumors, where it suppresses or inhibits the severe diarrhea and flushing episodes associated with the disease, and for the treatment of profuse watery diarrhea associated with VIP-secreting tumors.
• This summary is based on the review of 10 systematic review(s)/meta-analysis(es). ^[1-10]
• In patients with acromegaly and neuroendocrine tumors (NETs), octreotide long-acting release (OCT) therapy maintained normal insulin-like growth factor I (IGF-I) levels in ≥ 70% of cases, with similar outcomes observed with lanreotide and pegvisomant, alone or in combination with somatostatin receptor ligands (SRLs).
• In the management of chyle leaks post-neck dissection, octreotide demonstrated effectiveness, with a reduction in chyle output observed within 2-4 days and complete resolution achieved in 2-11 days.
• Prophylactic administration of octreotide during surgery for NETs did not significantly reduce the risk of intraoperative carcinoid crisis.
• For type-1 gastric neuroendocrine tumors, octreotide treatment resulted in a complete response rate ranging from 25% to 100%, with a pooled cumulative response rate of 84.5% across six prospective studies.
• The safety profiles of octreotide (OCT) with extended dosing intervals and standard regimens were comparable, with non-serious adverse events reported similarly in both home and healthcare settings.
• No significant adverse effects were reported in studies focused on the use of OCT for chyle leaks, carcinoid crisis prevention during NET surgery, or treatment of type-1 gastric neuroendocrine tumors. OCT was well-tolerated in combination treatments, with only mild side effects that did not necessitate drug withdrawal.
• The safety of OCT was found to be similar to that of lanreotide (LAN) in both home and healthcare settings, with no notable safety advantage of OCT over other somatostatin analogs (SSAs) or in combined treatment regimens.
• There is no population type or subgroup information available in the reviewed studies.