Octreotide Use in Neonates: A Case Series

Overview

Journal Drugs R D

Specialty Pharmacology

Date 2018 Jun 28

PMID 29948779

Citations 8

Authors

Syed Ahmed Zaki

Mohan B Krishnamurthy

Atul Malhotra

Affiliations

Soon will be listed here.

Abstract

Background And Objective: Octreotide is a somatostatin analogue and has been used off-label for a variety of conditions. There are no specific guidelines for the use of octreotide in neonates and its safety and efficacy have not been systematically evaluated. The objective of this study is to present our experience of using octreotide therapy in neonates.

Methods: This is a retrospective study of neonates who received octreotide therapy during their hospital stay over a 15 years period (2003-2017) in a tertiary neonatal centre. The demographic details and indications of octreotide therapy including time of initiation, route, dose, duration and adverse effects of therapy were noted. The clinical course following octreotide administration was also analysed.

Results: Eleven neonates received octreotide therapy during the study period, of which nine had chylothorax and two had chylous ascites. Resolution of the chylous effusion with octreotide therapy was achieved in 4 out of 11 (36.3%) of the cases. The median duration of octreotide therapy in cases with successful resolution was 17.5 days. With the exception of minor side effects such as hyperglycaemia, none of the patients had any significant side effects that required discontinuation of therapy.

Conclusion: Octreotide was used safely as an adjunctive therapy for the treatment of chylothorax and chylous ascites in neonates. However, larger prospective controlled trials are required to establish the optimal dose, time of initiation, duration and efficacy of octreotide therapy in neonates.

Citing Articles

Propranolol As a Treatment Option for Chylous Effusions and Chylous Ascites in Fetuses and Neonates: A Systematic Review.

Courteau B, Zarlenga G, Narciso-Owen S, Nemec Ii E, Rose S J Pediatr Pharmacol Ther. 2024; 29(5):468-474.

PMID: 39411407 PMC: 11472413. DOI: 10.5863/1551-6776-29.5.468.

Sudan black poisoning resulted in methemoglobinemia in a baby with congenital chyloperitoneum.

Padari H, Kipper K, Eelmae I, Nerman J, Lintrop M, Metsvaht T Clin Case Rep. 2024; 12(4):e8676.

PMID: 38585587 PMC: 10995245. DOI: 10.1002/ccr3.8676.

Off-label use of drugs in pediatrics: a scoping review.

Meng M, Lv M, Wang L, Yang B, Jiao P, Lei W Eur J Pediatr. 2022; 181(9):3259-3269.

PMID: 35831681 DOI: 10.1007/s00431-022-04515-7.

Chylous ascites following repair of total anomalous pulmonary venous connection coexisting with a persistent left superior vena cava in a neonate: a case report.

Zeng W, Hu Y, Feng J, Luo X Transl Pediatr. 2021; 10(1):188-193.

PMID: 33633952 PMC: 7882300. DOI: 10.21037/tp-20-258.

Chemical pleurodesis and somatostatin in treating spontaneous chylothorax in pediatric patients: a retrospective analysis and review of the literature.

Long W, Cai B, Deng J, Liu Y, Wang W, Luo J Transl Pediatr. 2020; 9(4):551-560.

PMID: 32953553 PMC: 7475317. DOI: 10.21037/tp-20-199.

References

McMahon A, Wharton G, Thornton P, De Leon D . Octreotide use and safety in infants with hyperinsulinism. Pharmacoepidemiol Drug Saf. 2016; 26(1):26-31. PMC: 5286465. DOI: 10.1002/pds.4144. View

Testoni D, Hornik C, Neely M, Yang Q, McMahon A, Clark R . Safety of octreotide in hospitalized infants. Early Hum Dev. 2015; 91(7):387-92. PMC: 4450124. DOI: 10.1016/j.earlhumdev.2015.04.008. View

Harris A, Kokoris S, Ezzat S . Continuous versus intermittent subcutaneous infusion of octreotide in the treatment of acromegaly. J Clin Pharmacol. 1995; 35(1):59-71. DOI: 10.1002/j.1552-4604.1995.tb04746.x. View

Bellini C, Cabano R, Angelis L, Bellini T, Calevo M, Gandullia P . Octreotide for congenital and acquired chylothorax in newborns: A systematic review. J Paediatr Child Health. 2018; 54(8):840-847. DOI: 10.1111/jpc.13889. View

Yin R, Zhang R, Wang J, Yuan L, Hu L, Jiang S . Effects of somatostatin/octreotide treatment in neonates with congenital chylothorax. Medicine (Baltimore). 2017; 96(29):e7594. PMC: 5521940. DOI: 10.1097/MD.0000000000007594. View

Young S, Dalgleish S, Eccleston A, Akierman A, Mcmillan D . Severe congenital chylothorax treated with octreotide. J Perinatol. 2004; 24(3):200-2. DOI: 10.1038/sj.jp.7211053. View

Haugen B . Drugs that suppress TSH or cause central hypothyroidism. Best Pract Res Clin Endocrinol Metab. 2009; 23(6):793-800. PMC: 2784889. DOI: 10.1016/j.beem.2009.08.003. View

Bellini C, Ergaz Z, Radicioni M, Forner-Cordero I, Witte M, Perotti G . Congenital fetal and neonatal visceral chylous effusions: neonatal chylothorax and chylous ascites revisited. A multicenter retrospective study. Lymphology. 2013; 45(3):91-102. View

Arevalo R, Bullabh P, Krauss A, AULD P, Spigland N . Octreotide-induced hypoxemia and pulmonary hypertension in premature neonates. J Pediatr Surg. 2003; 38(2):251-3. DOI: 10.1053/jpsu.2003.50056. View

10.

Church J, Antunez A, Dean A, Matusko N, Deatrick K, Attar M . Evidence-based management of chylothorax in infants. J Pediatr Surg. 2017; 52(6):907-912. DOI: 10.1016/j.jpedsurg.2017.03.010. View

11.

Landis M, Butler D, Lim F, Keswani S, Frischer J, Haberman B . Octreotide for chylous effusions in congenital diaphragmatic hernia. J Pediatr Surg. 2013; 48(11):2226-9. PMC: 3882085. DOI: 10.1016/j.jpedsurg.2013.05.064. View

12.

Caverly L, Rausch C, Da Cruz E, Kaufman J . Octreotide treatment of chylothorax in pediatric patients following cardiothoracic surgery. Congenit Heart Dis. 2010; 5(6):573-8. DOI: 10.1111/j.1747-0803.2010.00464.x. View

13.

Jarir R, Rahman S, Bassiouny I . Use of octeriotide in the management of neonatal chylothorax secondary to repair of congenital diaphragmatic hernia: a report of two cases and review of literature. J Clin Neonatol. 2013; 1(2):91-5. PMC: 3743138. DOI: 10.4103/2249-4847.96767. View

14.

van der Steen I, van Albada M, Mohnike K, Christesen H, Empting S, Salomon-Estebanez M . A Multicenter Experience with Long-Acting Somatostatin Analogues in Patients with Congenital Hyperinsulinism. Horm Res Paediatr. 2017; 89(2):82-89. DOI: 10.1159/000485184. View

15.

Shah D, Sinn J . Octreotide as therapeutic option for congenital idiopathic chylothorax: a case series. Acta Paediatr. 2011; 101(4):e151-5. DOI: 10.1111/j.1651-2227.2011.02529.x. View

16.

Naranjo C, Busto U, Sellers E, Sandor P, Ruiz I, Roberts E . A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981; 30(2):239-45. DOI: 10.1038/clpt.1981.154. View

17.

Moreira-Pinto J, Rocha P, Osorio A, Bonet B, Carvalho F, Duarte C . Octreotide in the treatment of neonatal postoperative chylothorax: report of three cases and literature review. Pediatr Surg Int. 2010; 27(8):805-9. DOI: 10.1007/s00383-010-2730-2. View

18.

Goyal A, Smith N, Jesudason E, Kerr S, Losty P . Octreotide for treatment of chylothorax after repair of congenital diaphragmatic hernia. J Pediatr Surg. 2003; 38(8):E19-20. DOI: 10.1016/s0022-3468(03)00294-x. View

19.

Paget-Brown A, Kattwinkel J, Rodgers B, Michalsky M . The use of octreotide to treat congenital chylothorax. J Pediatr Surg. 2006; 41(4):845-7. DOI: 10.1016/j.jpedsurg.2005.12.041. View

20.

Das A, Shah P . Octreotide for the treatment of chylothorax in neonates. Cochrane Database Syst Rev. 2010; (9):CD006388. DOI: 10.1002/14651858.CD006388.pub2. View