Immunomodulatory therapies for acute pancreatitis

Table 2 Clinical trials of octreotide in acute pancreatitis

Ref.	Study design	Severity of AP	No.	interval	Dosage and administration	Major variables	Outcomes
Wang et al[89], 2013	Prospective RCT	P-SAP; SAP	P-SAP: 236	< 48 h	50 μg/h, continued i.v., × 3 d + 25 μg/h, continued i.v., × 4 d, or 25 μg/h, continued i.v., × 7 d	APACHE II, SIRS score, and MOF score Local complication	Positive at higher dosage
			SAP: 136			IL6, TNF-α
Yang et al[90], 2012	Multi-center	MAP	161	< 48 h	50 μg/h, continued i.v., × 3 d	APACHE II and MOF score	Positive
	RCT					Local complication
						IL6, TNF-α
Nikou et al[91], 2004	Prospective RCT	MAP	36	< 12 h	200 or 500 μg, i.h., 3 times/d × 5 d	IL-6, C-reactive protein	Positive IL-6 outcome at higher dosages
Beechey-Newman[93], 1993	Prospective case-control study	MAP	19	N	250 μg, i.h., then 0.5 μg/kg per hour, continued i.v., × 10 d	Biochemical and physiological parameters	Positive in serum calcium, albumin, hematocrit, hemoglobin, PaO2
Binder et al[94], 1994	Prospective trial	Mix	8	N	100, 200 or 500 μg, i.h., 3 times/d × 10 d	Complications	Positive at two higher dosages
Paran et al[95], 1995	Multi-center RCT	MAP	38	N	100 μg, i.h., 3 times/d × 14 d	Organ dysfunction	Positive in organ dysfunction and length of hospital stay
						Local complications
						Length of hospital stay
						Mortality
Fiedler et al[96], 1996	Prospective	SAP	39	N	100 μg, i.v., 3 times/d × 10 d	Organ dysfunction	Positive
	case-control study					Mortality
McKay et al[97], 1997	Multi-center RCT	Mix	58	N	40 μg/h, continued, i.v., × 5 d	Complications	Negative
						Mortality
Karakoyunlar et al[98], 1999	Prospective controlled study	Mix	43	N	250 μg/h, continued i.v., × 2 d	Biochemical, physiological and	Positive outcomes for serum amylase levels, pancreatic edema and earlier return to oral intake
						radiological changes
						Mortality
Paran et al[99], 2000	Case-controlled study	Mix	50	N	100 μg, i.h., 3 times/d, × 14 d	Organ dysfunction	Positive in organ dysfunction, length of hospital stay and mortality
						Local complications
						Length of hospital stay
						Mortality
Nikou et al[100], 2001	Prospective RCT	Mix	120	N	100, 200 or 300 μg, i.h.,	Duration of pain	Little benefit only at two higher dosages
					3 times/d, × 7 d	Organ dysfunction
						Local complications

AP: Acute pancreatitis; No.: Number of patients; Interval: the time interval between AP onset and the initiation of octreotide treatment; RCT: Randomized controlled trial; MAP: Mild acute pancreas; SAP: Severe acute pancreas; Mix: Mixture of MAP and SAP; P-SAP: Predicted SAP; N: Not mentioned; i.h.: Subcutaneous infusion; i.v.: Intravenous infusion; APACHE: Acute Physiology and Chronic Health Evaluation scale; SIRS: Systemic inflammatory response syndrome scale; MOF: Multiple organ failurescale; IL: Interleukin; TNF-α: Tumor necrosis factor-α; PaO2: Arterial oxygen partial pressure.