Somatostatin inhibits gastric acid secretion more effectively than pantoprazole in patients with peptic ulcer bleeding: a prospective, randomized, placebo-controlled trial

• Published in: Scandinavian journal of gastroenterology Vol. 40; no. 5; p. 515
• Main Authors: Avgerinos, Alec, Sgouros, Spiros, Viazis, Nikos, Vlachogiannakos, John, Papaxoinis, Kostis, Bergele, Christina, Sklavos, Pantelis, Raptis, Sotiris A
• Format: Journal Article
• Language: English
• Published: England 01.05.2005
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles; Anti-Ulcer Agents - therapeutic use; Benzimidazoles - therapeutic use; Double-Blind Method; Female; Gastric Acid - secretion; Gastric Acidity Determination; Hormones - therapeutic use; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Omeprazole - analogs & derivatives; Omeprazole - therapeutic use; Peptic Ulcer Hemorrhage - drug therapy; Prospective Studies; Proton Pump Inhibitors; Somatostatin - therapeutic use; Sulfoxides - therapeutic use
• ISSN: 0036-5521; 1502-7708
• DOI: 10.1080/00365520510015458

Gastric acid inhibition is beneficial in the management of peptic ulcer bleeding (PUB). The aim of this double-blind study was to test whether somatostatin (SST) increases intragastric pH in PUB as compared with pantoprazole (PAN) and placebo (PLA). Eligible patients were randomized to receive SST (500 microg/h+250 microg bolus), or PAN (8 mg/h+80 mg bolus) or PLA (normal saline) i.v., for 24 h. All patients underwent gastric pH monitoring during the infusion of the trial drugs. The three groups (SST, n=14; PAN, n=14; PLA, n=15) were comparable for age, gender, aetiology of PUB and laboratory data at admission. Mean (+/-SE) baseline pH levels in the fundus increased during the administration of the trial drugs (SST: 1.94+/-0.18 to 6.13+/-0.37, p<0.0001; PAN: 1.93+/-0.16 to 5.65+/-0.37, p<0.0001; PLA: 1.86+/-0.12 to 2.10+/-0.15, p=0.0917). During the first 12 h of infusion, the mean (+/-SE) percentage time spent above pH 4.0 and 5.4 was higher with SST versus PAN (84.4%+/-4.8 versus 55.1%+/-8.3, p=0.0049 and 74.2%+/-6.5 versus 47.1%+/-8.3, p=0.0163, respectively) and there was a trend favouring the SST group regarding the time spent above pH 6.0 and 6.8 (65.7%+/-6.4 versus 43.3%+/-8.2, p=0.0669 and 49.2%+/-7.7 versus 28.4+/-6.6, p=0.0738, respectively). In PUB, both SST and PAN inhibit gastric acid secretion as compared with placebo. However, during the first 12 h of the infusion, SST was more effective than PAN in maintaining high intragastric pH. These results may provide a rationale for the administration of SST in PUB.