Lanreotide in the management of small bowel angioectasias: seven-year data from a tertiary centre

Zammit, Stefania Chetcuti; Sanders, DS; Sidhu, Reena

doi:10.1080/00365521.2017.1325929

Cited by 4 publications

(11 citation statements)

References 73 publications

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“…Initial literature search provided 3455 articles; after duplicates removal, 2774 titles were assessed, with 93 articles considered eligible for further evaluation. Of them, 68 articles were excluded for various reasons, leaving 25 studies to be included in our systematic review and meta-analysis [11–13,17–38]. The study’s flowchart is illustrated in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…They were published between 1992 and 2020, enrolling 765 patients in total. Sixteen studies were conducted in Europe [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32], six in USA [12,13,[33][34][35][36], two in China [37,38] and one in Argentina [11]. The majority of the included studies were either retrospective [12,13,[25][26][27]29,31,33,34,37] or prospective [17,18,20,[22][23][24]36] observational studies, whereas one ambispective observational study and one matched cohort study were also included [11,35].…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Sixteen studies were conducted in Europe [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32], six in USA [12,13,[33][34][35][36], two in China [37,38] and one in Argentina [11]. The majority of the included studies were either retrospective [12,13,[25][26][27]29,31,33,34,37] or prospective [17,18,20,[22][23][24]36] observational studies, whereas one ambispective observational study and one matched cohort study were also included [11,35]. Finally, four randomized controlled trials (RCTs) were considered eligible for inclusion: three comparing pharmacologic treatment with placebo [19,30,32] and one comparing pharmacologic treatment with iron supplementation…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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Efficacy of pharmacologic treatment for treating gastrointestinal angiodysplasias-related bleeding: a systematic review and meta-analysis

Gkolfakis

Fostier

Tziatzios

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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Introduction We evaluated the efficacy of pharmacologic treatments for patients with overt or occult bleeding due to gastrointestinal angiodysplasias (GIADs). Methods A systematic computer-aided literature search across Medline, Cochrane, Scopus and Embase databases was performed. Studies evaluating pharmacologic treatments for patients presenting with GIADs-related overt or occult bleeding were included. Post-treatment rebleeding was the primary outcome. Need for red blood cells (RBC) transfusion, post-treatment hemoglobin levels and adverse events rate comprised secondary outcomes. Results are presented as odds ratio (OR), mean difference (MD) or pooled rates (%) with 95% confidence intervals (95%CI). Results Four types of pharmacologic treatment were identified (25 studies): somatostatin analogs, hormonal therapy, thalidomide and angiogenesis inhibitors. Pharmacologic treatment of any kind led to significantly reduced bleeding episodes [OR (95% CI), 0.08 (0.04–0.18)]. No pharmacologic treatment was superior to others (P = 0.46). Overall, pooled rebleeding rate post-treatment was 34% (26–43%). Similarly, significantly fewer patients required RBC transfusion during the post-treatment period [0.03 (0.03–0.07)], with no differences among various treatments (P = 0.83), yielding an overall pooled transfusion rate of 33% (19–46%). Administration of pharmacological treatment led to significant improvement in terms of hemoglobin levels [MD (95% CI), 3.21 g/dL (2.42–3.99)]. The pooled rate of adverse events was 32% (22–42%). Conclusion In patients with GIADs administration of any pharmacologic treatment significantly decreases rebleeding episodes and transfusions leading to higher hemoglobin values. One-third of them experience at least one adverse event related to the treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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Efficacy of pharmacologic treatment for treating gastrointestinal angiodysplasias-related bleeding: a systematic review and meta-analysis

Gkolfakis

Fostier

Tziatzios

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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“…The results are promising, as they demonstrated a significant reduction in rebleeding rates (P=0.002), hemoglobin reduction and transfusion requirements [ 62 ]. Future research will also need to concentrate on dosing and duration of treatment with somatostatin analogues, since trials so far have not been uniform, making it difficult to draw a comparison [ 63 - 68 ].…”

Section: Noninvasive Managementmentioning

confidence: 99%

Management of small bowel angioectasias diagnosed during video capsule endoscopy

Sciberras¹

2023

aog

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Small bowel angioectasias (SBA) are vascular malformations consisting of thin-walled, dilated capillaries located in the gastrointestinal mucosa. They are responsible for 10% of all causes of gastrointestinal bleeding and 60% of small bowel bleeding pathologies. The diagnosis and management of SBA depend upon bleeding acuity, patient stability and patient characteristics. Small bowel capsule endoscopy is a relatively noninvasive diagnostic approach ideal for non-obstructed and hemodynamically stable patients. It is superior to computed tomography scans in visualizing mucosal lesions, such as angioectasias, as it provides mucosal views. Management of these lesions will depend on the patient’s clinical condition and associated comorbidities, and very often consists of medical and/or endoscopic treatment delivered through small bowel enteroscopy.

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“…Despite the promising utility of somatostatin analogs, prolonged use is potentially associated with an increased risk of adverse events. Consequently, the efficacy of lanreotide, which is thought to be less toxic and better tolerated, has been recently evaluated for the management of bleeding from intestinal ADs[71].…”

Section: Treatmentmentioning

confidence: 99%

Diagnosis and therapeutic strategies for small bowel vascular lesions

Shimizu

Ohata

Nakajima

et al. 2019

WJG

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Small bowel vascular lesions, including angioectasia (AE), Dieulafoy’s lesion (DL) and arteriovenous malformation (AVM), are the most common causes of obscure gastrointestinal bleeding. Since AE are considered to be venous lesions, they usually manifest as a chronic, well-compensated condition. Subsequent to video capsule endoscopy, deep enteroscopy can be applied to control active bleeding or to improve anemia necessitating blood transfusion. Despite the initial treatment efficacy of argon plasma coagulation (APC), many patients experience re-bleeding, probably because of recurrent or missed AEs. Pharmacological treatments can be considered for patients who have not responded well to other types of treatment or in whom endoscopy is contraindicated. Meanwhile, a conservative approach with iron supplementation remains an option for patients with mild anemia. DL and AVM are considered to be arterial lesions; therefore, these lesions frequently cause acute life-threatening hemorrhage. Mechanical hemostasis using endoclips is recommended to treat DLs, considering the high re-bleeding rate after primary APC cauterization. Meanwhile, most small bowel AVMs are large and susceptible to re-bleeding therefore, they usually require surgical resection. To achieve optimal diagnostic and therapeutic approaches for each type of small bowel lesion, the differences in their epidemiology, pathology and clinical presentation must be understood.

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Lanreotide in the management of small bowel angioectasias: seven-year data from a tertiary centre

Abstract: Lanreotide is a useful adjuvant treatment to therapeutic enteroscopy in patients with refractory obscure gastrointestinal bleeding due to SBAs. It improves haemoglobin levels, reduces transfusion requirements, bleeding episodes and number of DBEs. Overall, it has a good safety profile.

Cited by 4 publications

References 73 publications

Efficacy of pharmacologic treatment for treating gastrointestinal angiodysplasias-related bleeding: a systematic review and meta-analysis

Efficacy of pharmacologic treatment for treating gastrointestinal angiodysplasias-related bleeding: a systematic review and meta-analysis

Management of small bowel angioectasias diagnosed during video capsule endoscopy

Diagnosis and therapeutic strategies for small bowel vascular lesions

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