Priyadarshini Loganathan, MD1, Ashle Lao, MS2, Sahib Singh, MD3, Sheza Malik, MD4, Mahesh Gajendran, MD5, Babu Mohan, MD6, Albert Machuca, BSA2, Hemant Goyal, MD7 1UT Health, San Antonio, TX; 2University of Texas Health San Antonio, San Antonio, TX; 3Sinai Hospital, Baltimore, MD; 4Rochester General Hospital, New York, NY; 5UT, San Antonio, TX; 6Orlando Gastroenterology PA, Orlando, FL; 7Groover Clinic, Orlando, FL
Introduction: Background: Gastrointestinal angiodysplasias are vascular malformations (GI-AVMs) that often cause chronic bleeding leading to packed red blood cell (PRBC) transfusion-dependent anemia. Several studies suggest that somatostatin analogs may decrease rebleeding rates and decrease the need for PRBC transfusions, but the true effect size is unknown. We, therefore, aim to investigate the efficacy of somatostatin analogues on PRBC transfusion requirements in patients with GI-AVMs by performing this systematic review and meta-analysis.
Methods: We conducted a comprehensive search of Ovid Medline, Ovid Embase, Cochrane Central, Scopus, and Web of Science from inception to February 2024 for studies evaluating the efficacy and safety of somatostatin analog in GI-AVMs. A random effect model was used to perform the metanalysis, and heterogeneity was assessed using the I2 statistics. The primary outcomes were clinical response rate, differences in mean PRBC transfusion, and hemoglobin levels. The secondary outcomes were patients without rebleeding episodes and adverse events of long-acting somatostatin analogues, such as Lanreotide, Octreotide, and Pasreotide.
Results: Fifteen studies were included in the final analysis which included 371 patients. The pooled Clinical Response was 67% (58% - 75%), I2 = 50%, and the pooled without rebleeding was 57% (42% - 70%), I2 = 73%. The pooled OR of patients requiring PRBC transfusion in control vs. SA-treated group was 17 (6.7 - 44), I2 = 42% p = 0.00). The pooled standard difference in mean Hemoglobin levels between the treated group vs. the control group was 2 gm/dl (1.1 gm/dl - 2.7 gm/dl), I2 = 90%, p = 0.00. The total adverse events in the treated group were 18% (9% - 31%), I2 = 7% (Table 1)
Discussion: Conclusion: This meta-analysis comprising 371 patients with GI angiodysplasia from 15 studies demonstrated somatostatin analog therapy is safe and effective in most patients with PRBC-dependent bleeding due to GI-AVMs.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Priyadarshini Loganathan indicated no relevant financial relationships.
Ashle Lao indicated no relevant financial relationships.
Sahib Singh indicated no relevant financial relationships.
Sheza Malik indicated no relevant financial relationships.
Mahesh Gajendran indicated no relevant financial relationships.
Babu Mohan indicated no relevant financial relationships.
Albert Machuca indicated no relevant financial relationships.
Hemant Goyal indicated no relevant financial relationships.
Priyadarshini Loganathan, MD1, Ashle Lao, MS2, Sahib Singh, MD3, Sheza Malik, MD4, Mahesh Gajendran, MD5, Babu Mohan, MD6, Albert Machuca, BSA2, Hemant Goyal, MD7. P4170 - Efficacy and Safety of Somatostatin Analogue in Chronic Bleeding From Gastrointestinal Angiodysplasia: A Systematic Review and Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
