Octreotide 5mg

Octreotide is a synthetic polypeptide chain consisting of 8 amino acids. Its main function is to mimic the action of somatostatin, which is a potent inhibitor of natural growth hormone, glucagon, insulin, and gastric acid secretion. Because of this action, it is best known for its potential therapeutic role in the treatment of acromegaly, but also for its antisecretory effects (as a complementary therapeutic measure in the case of postoperative chylothorax).

In addition, it may be effective as an antidiarrheal supplement (when diarrhea is a consequence of AIDS or gastrointestinal tumors). Octreotide also has an antihemorrhagic effect (which may be useful in the case of bleeding gastroesophageal varices), antihypoglycemic (a potential therapeutic measure in various pancreatic tumors), and antihypotensive effect (which has a possible application in carcinoid crises). This peptide is increasingly being used in cases of major pancreatic surgery because it is thought that it may be able to reverse major post-operative complications.

Octreotide Research Benefits

The Effect of Octreotide on Acromegaly

Acromegaly is a rare disease caused by excess growth hormone. The most common cause of the disease is a benign pituitary tumor (very often an adenoma). Many patients are not candidates for surgical treatment due to the severity of the condition, or after attempted surgery, the desired results were not achieved. Previously, in such cases, somatostatin receptor ligands (SRLs) were the mainstay of medical therapy. This therapy is most often administered in the form of injections, and according to many studies, it is assumed that they can be effective in achieving biochemical and radiological control of acromegaly. However, not all patients respond to this therapy, so that oral Octreotide may be an ideal solution and alternative treatment. The new formulation may potentially be equally safe and effective.

Oral Octreotide Capsules (OCC) always combine Octreotide with a method to improve luminal permeability. Results from 4 different but pivotal clinical trials have shown significant and effective suppression of growth hormone and insulin-like growth factor-1 (GH and IGF-1) levels. In total, the studies included 238 patients with acromegaly treated with Octreotide capsules. 

In addition to reduced hormone levels, it has been shown it is easier and more effective in maintaining disease control and reducing symptoms. Patients also noted symptomatic improvement, which is most important. Compared to somatostatin receptor ligands (SRL) injections, most patients preferred oral Octreotide capsules compared to other options. Therefore, oral therapy with this peptide could potentially be a more effective and better option for the treatment of patients with acromegaly.

The Role of Octreotide in the Prevention of Postoperative Pancreatic Surgery Complications

Postoperative complications after major pancreatic surgery are relatively common and are mainly due to the formation of an improper anastomosis between the stomach or small intestine and the pancreas. Pancreatic juice secretion and the structure of the pancreatic soft tissue are the main risk factors. 

One of the numerous studies addressed the prevention of these complications, summarizing six double-blind studies in which subjects received a placebo and one open-label randomized trial in which subjects received Octreotide subcutaneously. All patients underwent major pancreatic surgery. Patients received either Octreotide or placebo for 5-7 days, starting at least once before surgery. The most common postoperative complications that occurred earlier were anastomotic leak, pancreatic fistula, abscess, shock, sepsis, pulmonary failure, renal failure, bleeding, postoperative pancreatitis, and even death. The results of this pooled study showed significantly decreased postoperative complications in the Octreotide group compared with the placebo group.

The effect of this peptide was most pronounced in preventing complications such as fistula, fluid collection, and anastomotic leakage. The results suggest that inhibition of perioperative secretion can significantly prevent complications after surgery, which can potentially be achieved by using Octreotide peptide.

Octreotide's Association with the Treatment of Secretory Diarrhea

Diarrhea is a condition of accelerated intestinal emptying and occurs as a consequence of various diseases. Numerous studies and research results suggest that Octreotide could be an effective therapeutic measure in the control and treatment of secretory diarrhea of various etiologies (infectious and non-infectious nature). However, depending on the cause and the condition, there are significant differences in the titration of the peptide dose. 

In cases where diarrhea is a consequence of gastrointestinal tumors (carcinomas, vipomas), AIDS, dumping syndrome, short bowel syndrome, radiotherapy, or chemotherapy, an aggressive initial dose is advised. However, in patients with diabetes mellitus as an associated disease, a low initial dose of the peptide is advised in order to avoid hypoglycemia. Octreotide is very well tolerated in such conditions. For many patients with secretory diarrhea, it is thought that Octreotide therapy can improve stool consistency and reduce stool volume, improving overall health and quality of life.

Summary

This amino acid sequence achieves several potential beneficial effects by mimicking the action of the natural hormone somatostatin. Just a few of those described are a potential therapeutic effect in the treatment of patients with acromegaly (by suppressing growth hormone secretion), the prevention of postoperative complications after major pancreatic surgery (through its antisecretory effect) and similarly, it may be effective in the treatment of secretory diarrhea if titrated appropriately. Octreotide will certainly be studied further in the future and thus may further establish its place in the therapeutic treatment of these conditions. 

Resources:

•     Remba-Shapiro I, Nachtigall LB. Treatment of acromegaly with oral octreotide. Best Pract Res Clin Endocrinol Metab. 2024 Jul;38(4):101888. 
•     Stajich, G. V., & Ashworth, L. (2006). Octreotide. Neonatal Network: The Journal of Neonatal Nursing, 25(5), 365–369. 
•     Yuen KCJ, Samson SL. Oral Octreotide: A Review of Recent Clinical Trials and Practical Recommendations for Its Use in the Treatment of Patients With Acromegaly. Endocr Pract. 2022 Jun;28(6):637-645. 
•     Berberat PO, Friess H, Uhl W, Büchler MW. The role of octreotide in the prevention of complications following pancreatic resection. Digestion. 1999;60 Suppl 2:15-22. 
•     Harris AG, O'Dorisio TM, Woltering EA, Anthony LB, Burton FR, Geller RB, Grendell JH, Levin B, Redfern JS. Consensus statement: octreotide dose titration in secretory diarrhea. Diarrhea Management Consensus Development Panel. Dig Dis Sci. 1995 Jul;40(7):1464-73.