LONG-TERM TREATMENT WITH OCTREOTIDE IN PATIENTS WITH THE ZOLLINGER-ELLISON SYNDROME

This study reports the effects of 4 and 5-year treatment with octreoti de (200 mug sc bid) in the Zollinger-Ellison syndrome (ZES). No sympto ms related to acid hypersecretion were observed in the four patients t hroughout the study, and upper GI endoscopy was normal. Basal acid out put (BAO) measured 12 h after injection, was below 10 mmol h-1 in thre e to four patients and previous ranitidine treatment was discontinued. In the fourth case (pretreatment BAO value: 115 mmol h-1), BAO progre ssively decreased to 42 mmol h-1 after 5 years of octreotide treatment . At the end of the study, serum gastrin levels were 58.5% (30-68) of the pretreatment values and two patients had normal gastrin levels. Pe ak acid output (PAO) decreased markedly after 2, 4 and 5 years, by 68% (35-89) suggesting that octreotide had exerted an antitrophic effect on parietal cell mass. Diffuse hyperplasia of fundic argyrophil cells present in two patients before octreotide, decreased during the treatm ent. Mean argyrophil cell density for all patients was not significant ly modified. Antral gastrin-cell density was in the normal range. No l ong-term side effect of octreotide treatment was observed. Although oc treotide may not be considered as a substitute for benzimidazoles in t he treatment of ZES, its specific properties may be of therapeutic ben efit in some ZES patients.