Comparison of Terlipressin, Somatostatin, and Octreotide for Control of Variceal Bleeding
Korea University1,034 participantsSept 2006 to May 2010
Variceal Bleeding, Cirrhosis
In PepBank now:147 peptides, 6 blends and 13 other compounds97,577 study results from 17,383 studies8,473 clinical trialsUpdated
Comparing 2 peptides · Data version 308560
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| Peptide | Synthetic analog Octreotide | Synthetic analog Lanreotide | |
|---|---|---|---|
| Identity | |||
| Kind | Synthetic analog | Synthetic analog | |
| Area | Growth hormone axis | Growth hormone axis | |
| Evidence | |||
| Amount of evidence | 816 | 585 | |
| Evidence level | Has results from studies in people | Has results from studies in people | |
| Safety | |||
| Safety results | 118 (116 in people) | 98 (98 in people) | |
| Status | |||
| Approval | |||
| Sport (WADA) | |||
| Registered trials | 256 · 30 active63 more mention it but do not test it | 85 · 8 active25 more mention it but do not test it | |
Shared outcomes
From the regulatory data of each peptide.
The FDA label for Sandostatin says: “Reduction of GH and IGF-1 in acromegaly after inadequate response to, or inability to receive, surgery, pituitary irradiation, and maximally tolerated bromocriptine”
Outcome groups with study results for at least two of these peptides. Counts include only results from studies that gave the peptide. Bar length is the number of results, on one scale. The bars show how much was studied, not how large an effect was. A peptide with more studies can look stronger here without being stronger. For results, see the randomized results above.
| Outcome group | Octreotide | Lanreotide |
|---|---|---|
| Growth hormone and IGF-1Kidney and urinary | 14513411 | 1181091 |
PepBank is a research reference. Talk to a doctor before you use any peptide.
The FDA label for Somatuline Depot says: “Adults with unresectable, well or moderately differentiated, locally advanced or metastatic gastroenteropancreatic neuroendocrine tumors, to improve progression-free survival”
| Tumor growthEndocrine and hormones | 654916 | 10688216 |
|---|
| Adverse eventsWhole body | 69672 | 6868 |
|---|
| Gastrointestinal protectionGastrointestinal | 91901 | 3535 |
|---|
| Glycemic controlMetabolic and weight | 4747 | 1616 |
|---|
| Gastrointestinal adverse eventsGastrointestinal | 3434 | 2626 |
|---|
| MortalityWhole body | 4040 | 1313 |
|---|
| PharmacokineticsPharmacology | 21192 | 2929 |
|---|
| Receptor activity and mechanismPharmacology | 35269 | 252419 |
|---|
| Gastrointestinal functionGastrointestinal | 2626 | 44 |
|---|
| Kidney functionKidney and urinary | 25169 | 1010 |
|---|
| Blood pressureLiver | 22202 | 541 |
|---|
Registered trials, ranked by phase (late phases first), then posted results and enrollment. Status is the registry status. Study results come from published studies. Results posted at ClinicalTrials.gov are shown on each trial page.
Top 3 of 256 trials, ranked by phase, then posted results and enrollment: 1 ongoing · 2 completed · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)
Korea University1,034 participantsSept 2006 to May 2010
Variceal Bleeding, Cirrhosis
Novartis Pharmaceuticals429 participantsDec 2006 to Jun 2013
Carcinoid Tumor · Malignant Carcinoid Syndrome
National Cancer Institute (NCI)427 participants1 Dec 2007 to est. 31 Jan 2027
Colorectal Neuroendocrine Tumor G1 · Gastric Neuroendocrine Tumor G1 · Neuroendocrine Neoplasm · Neuroendocrine Tumor · Neuroendocrine Tumor G2
63 more mention it but do not test it. They only measure it or name it in their text.
Top 3 of 85 trials, ranked by phase, then posted results and enrollment: 3 completed · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)
Ipsen264 participantsJun 2006 to Apr 2013
Endocrine Tumors
Novartis Pharmaceuticals198 participants19 Jul 2010 to 28 Feb 2017
Acromegaly
Ipsen128 participantsOct 2014 to 16 Feb 2017
Acromegaly
25 more mention it but do not test it. They only measure it or name it in their text.
For each outcome that two or more peptides have results for: the best result of a single randomized trial, on the same measure (the same kind of number, the same unit). When a trial has several dose arms, the cell shows the highest dose arm. The trials differ in people, length and dose, so a gap between two cells is not proof that one peptide works better.
| Outcome | Octreotide | Lanreotide |
|---|---|---|
| Growth hormone and IGF-1Endocrine and hormonesCompared as: value in the arm that got the peptide, in % | 19.2% Biochemical control rate Dose studied: 20 mg/28 days, with optional titration to 30 mg at months 3 and 712 monthsn = 3582014 | 41% Biochemical control · lanreotide SR (12 patients) n = 202002 |
| MortalityCancerCompared as: value in the arm that got the peptide, in months | 6.53 months Median overall survival Placebo group: 7.03 months Dose studied: 30 mg once every 4 weeksup to 2 yearsn = 2722009 | 9.5 months Median overall survival |
| Intensive care and hospital outcomesWhole bodyCompared as: value in the arm that got the peptide, in days | 9 days Median postoperative length of hospital stay Saline control arm: 9 days Dose studied: 250 microg every 8 hours7 daysn = 2112000 | 4.5 days |
| Gastrointestinal protectionGastrointestinalCompared as: value in the arm that got the peptide, in % | −66% Reduction in fistula output at 24 h · Shown as a change. The study reports a reduction in fistula output at 24 h of this size. · octreotide plus parenteral nutrition; SD 43 Placebo plus parenteral nutrition; SD 47: −68% Dose studied: 100 micrograms every 8 hn = 311995 | |
| Tumor growthCancerCompared as: difference from placebo, in p | 0.000072 P P value Dose studied: 30 mg monthlyn = 852009 | 0.93 p P value |
| Liver fat and liver functionLiverCompared as: value in the arm that got the peptide, in ml | −71 ml Liver volume change on octreotide · mean; +/- 57; crossover octreotide period Dose studied: 40 mg every 28 days6 monthsn = 122010 | 4606 mL |
| Adverse eventsMetabolic and weightCompared as: value in the arm that got the peptide, in % | 18% Morbidity rate Control: 29.6% n = 1092015 | 14.3% Surgical morbidity |
19.2%
Biochemical control rate
Dose studied: 20 mg/28 days, with optional titration to 30 mg at months 3 and 712 monthsn = 3582014
41%
Biochemical control · lanreotide SR (12 patients)
n = 202002
The other peptides have no randomized result on the same measure, so these results cannot be set side by side.
| Outcome | Octreotide | Lanreotide |
|---|---|---|
| Kidney functionKidney and urinaryCompared as: difference from placebo, in ml/min/1.73 m2 per year | No comparable result 8 randomized-trial results measure it in another way or another unit. | −0.08 mL/min/1.73 m2 per year difference in annual eGFR decline Dose studied: 120 mg every 4 weeks2.5 yearsn = 309 |
Dose studied: 120 mg every 28 daysUp to 1 year or progressionn = 712019
Postoperative hospital stay, mean · lanreotide pretreatment, +/-1.6
Dose studied: 30 mg every 2 weeks, increased to weekly at week 8 if mean GH >2.5 microg/l4 monthsn = 982010
−45.1% Output reduction · Shown as a change. The study reports a output reduction of this size. Placebo: −8.9% Dose studied: 30 mg PRSingle first injection; outcome assessed at 72 hoursn = 1072009 |
Dose studied: 120 mg every 28 days72 weeksn = 442024
Baseline liver volume
Placebo: 4689 mL
Dose studied: 120 mg every 28 days24 weeksn = 542009
Dose studied: 30 mg every 2 weeks, increased to weekly at week 8 if mean GH >2.5 microg/l4 monthsn = 982010
6.53 months
Median overall survival
Placebo group: 7.03 months
Dose studied: 30 mg once every 4 weeksup to 2 yearsn = 2722009
9.5 months
Median overall survival · lanreotide, 95% CI 4.8-14.3
Dose studied: 120 mg every 28 daysUp to 1 year or progressionn = 712019
9 days
Median postoperative length of hospital stay
Saline control arm: 9 days
Dose studied: 250 microg every 8 hours7 daysn = 2112000
4.5 days
Postoperative hospital stay, mean · lanreotide pretreatment, +/-1.6
Dose studied: 30 mg every 2 weeks, increased to weekly at week 8 if mean GH >2.5 microg/l4 monthsn = 982010
−66%
Reduction in fistula output at 24 h · Shown as a change. The study reports a reduction in fistula output at 24 h of this size. · octreotide plus parenteral nutrition; SD 43
Placebo plus parenteral nutrition; SD 47: −68%
Dose studied: 100 micrograms every 8 hn = 311995
−45.1%
Output reduction · Shown as a change. The study reports a output reduction of this size.
Placebo: −8.9%
Dose studied: 30 mg PRSingle first injection; outcome assessed at 72 hoursn = 1072009
0.000072 P
P value
Dose studied: 30 mg monthlyn = 852009
0.93 p
P value
Dose studied: 120 mg every 28 days72 weeksn = 442024
−71 ml
Liver volume change on octreotide · mean; +/- 57; crossover octreotide period
Dose studied: 40 mg every 28 days6 monthsn = 122010
4606 mL
Baseline liver volume
Placebo: 4689 mL
Dose studied: 120 mg every 28 days24 weeksn = 542009
18%
Morbidity rate
Control: 29.6%
n = 1092015
14.3%
Surgical morbidity
Dose studied: 30 mg every 2 weeks, increased to weekly at week 8 if mean GH >2.5 microg/l4 monthsn = 982010
| Quality of lifeWhole bodyCompared as: difference from placebo, in units per year | No comparable result 1 randomized-trial result measure it in another way or another unit. | −0.03 units per year difference in quality-of-life change Dose studied: 120 mg every 4 weeks2.5 yearsn = 3092018 |
|---|
| Wound healingSkin and woundCompared as: difference from placebo, in p | No comparable result 2 randomized-trial results measure it in another way or another unit. | 0.18 P P value Dose studied: 90 mgn = 1452012 |
|---|
| PharmacokineticsPharmacologyCompared as: value in the arm that got the peptide, in l/h | 15.8 L/h Apparent clearance · octreotide 100 microg Dose studied: 100 microgsingle dosen = 122005 | No comparable result 11 randomized-trial results measure it in another way or another unit. |
|---|
| Blood pressureLiverCompared as: value in the arm that got the peptide, in % | No randomized trial result 22 results from other study designs. | −13.6% change in baseline HVPG · lanreotide SR 30 mg weekly Dose studied: 30 mg once weekly3 weeksn = 242003 |
|---|
No comparable result
8 randomized-trial results measure it in another way or another unit.
−0.08 mL/min/1.73 m2 per year
difference in annual eGFR decline
Dose studied: 120 mg every 4 weeks2.5 yearsn = 3092018
No comparable result
1 randomized-trial result measure it in another way or another unit.
−0.03 units per year
difference in quality-of-life change
Dose studied: 120 mg every 4 weeks2.5 yearsn = 3092018
No comparable result
2 randomized-trial results measure it in another way or another unit.
0.18 P
P value
Dose studied: 90 mgn = 1452012
15.8 L/h
Apparent clearance · octreotide 100 microg
Dose studied: 100 microgsingle dosen = 122005
No comparable result
11 randomized-trial results measure it in another way or another unit.
No randomized trial result
22 results from other study designs.
−13.6%
change in baseline HVPG · lanreotide SR 30 mg weekly
Dose studied: 30 mg once weekly3 weeksn = 242003