The following is a summary of “Standard of Care Versus Octreotide in Angiodysplasia-Related Bleeding (the OCEAN Study): A Multicenter Randomized Controlled Trial,” published in the April 2024 issue of Gastroenterology by Goltstein, et al.

Gastrointestinal angiodysplasias represent vascular anomalies that can lead to transfusion-dependent anemia despite undergoing endoscopic therapy. Although previous individual patient data meta-analyses from cohort studies suggested a potential decrease in rebleeding rates with octreotide, these studies had notable biases. Researchers conducted a clinical trial to investigate the efficacy of octreotide in reducing transfusion requirements among patients with angiodysplasia-related anemia.

The multicenter, open-label, randomized controlled trial enrolled patients with angiodysplasia bleeding who had received at least 4 units of red blood cells (RBCs) or parental iron infusions, or both, in the preceding year. Participants were randomly assigned (1:1) to receive either 40-mg octreotide long-acting release intramuscularly every 28 days or standard of care, including endoscopic therapy—the treatment period lasted 1 year. The primary outcome measured was the mean difference in the number of transfusion units (RBC + parental iron) between the octreotide and standard-of-care groups. Patients who received at least one octreotide injection or adhered to the standard of care for at least one month were included in the intention-to-treat analyses. Analyses of covariance were utilized to adjust for baseline transfusion requirements and incomplete follow-up.

About 62 patients (mean age, 72 years; 32 men) from 17 Dutch hospitals were enrolled, with 31 patients allocated to the octreotide and standard of care groups. In the year before enrollment, patients required a mean of 20.3 (standard deviation, 15.6) transfusion units and underwent an average of 2.4 (standard deviation, 2.0) endoscopic procedures. The total number of transfusions was significantly lower with octreotide (11.0; 95% confidence interval [CI], 5.5–16.5) compared to the standard of care (21.2; 95% CI, 15.7–26.7). Octreotide resulted in a mean reduction of 10.2 transfusion units (95% CI, 2.4–18.1; P = .012). Additionally, octreotide reduced the annual volume of endoscopic procedures by 0.9 (95% CI, 0.3–1.5).

Octreotide effectively reduces transfusion requirements and the necessity for endoscopic therapy in patients suffering from angiodysplasia-related anemia.

Reference: gastrojournal.org/article/S0016-5085(23)05685-8/fulltext