A Phase 2 interventional study of Lanreotide 90 mg slow release formulation and Placebo in Dumping Syndrome, sponsored by Universitaire Ziekenhuizen KU Leuven. Completed at 3 sites in Belgium. Open to participants aged 18 Years to 100 Years. Per ClinicalTrials.gov, last updated 2023-01-27.
Sponsored by Universitaire Ziekenhuizen KU Leuven · Phase 2, Interventional, and Treatment
The purpose of this study is to assess if Somatuline autogel 90 mg is effective in the treatment of dumping syndrome.
Dumping syndrome has characteristic alimentary and systemic manifestations. It is one of the most common postprandial syndromes observed after extensive gastric surgery. Dumping syndrome can be separated into an early and late phase depending on the occurrence of symptoms in relation to the time elapsed after a meal. The early phase occurs because of rapid delivery of large amounts of osmotic active solids and liquids into the duodenum. The late phase is caused by a rapid increase of the glycemia and insuline causing hypoglycemia when the nutrients are not available any more. Dumping syndrome is the direct result of alterations in the storage function of the stomach and/or the pyloric emptying mechanism.
Incidence and severity of symptoms in dumping syndrome are related directly to the extent of gastric surgery. An estimated 25-50% of all patients who have undergone gastric surgery have some symptoms of dumping. Only 1-5% are reported to have severe disabling symptoms. Incidence of significant dumping has been reported to be 6-14% in patients after truncal vagotomy and drainage and from 14-20% in patients after partial gastrectomy. Incidence of dumping syndrome after proximal gastric vagotomy without any drainage procedure is less than 2%. In the pediatric population, dumping syndrome is described in children who have undergone Nissen fundoplication.
Several treatments can be proposed to a patient with dumping. Initially a diet of several small meals with a low concentration of mono-and disaccharides is prescribed and the patient is asked to avoid liquids during a meal. Several medical treatments can be utilized as guar gum, to increase the viscosity and reduce gastric emptying; pectine, to avoid a late hypoglycemia; acarbose, to block the digestion of saccharides. Some of them have only a partial effect or important side effects.
Surgical interventions like an interposition of an antiperistaltic jejunal segment will reduce the intestinal motility or a Roux-en-Y construction can be created. These surgical interventions are sometimes necessary but remain quite invasive and not always useful.
Somatostatin analogues have been used with success in patients with dumping syndrome. They exert a strong inhibitory effect on the release of insulin and several gut-derived hormones. The effectiveness of analogues in controlling the symptoms of both early and late dumping has been demonstrated in several randomized control trials. Somatostatin analogues interfere with the pathophysiology of a dumping syndrome in several ways. Somatostatin analogues reduce the secretion of insulin and prevents the occurrence of a late hypoglycaemia; decrease the concentration of different hormones responsible for the vaso-dilatation and the activation of the renin-angiotensine system that is seen in the early faze of the dumping syndrome. Somatostatin has also an effect on gastric motility and transit time.
One of the main problems is the high cost and daily subcutaneous administration of somatostatin analogues .
Somatuline® Autogel is a slow-release formulation that requires only monthly injection and supply high-dose, stable serum levels of lanreotide. These agents provide improved patient compliance since they are administered on a monthly schedule.
The purpose of this study is to assess if Somatuline autogel 90 mg is effective in the treatment of dumping syndrome. This will be a 27 weeks double blinded placebo-controlled cross-over multicenter study assessing the effect of Somatuline 90 mg in patients with dumping syndrome.
Reports on the therapeutic effectiveness of lanreotide in the management of dumping symptoms are scarce and based on small numbers of patients. Data on the effect of lanreotide in the treatment of dumping are missing. In this trial, all patients will be treated with Somatuline ® Autogel 90 mg. From a pharmacokinetic point of view, all patients will have reached steady state concentration of lanreotide after 12 weeks of treatment. After 12 weeks, a wash-out period of 4 weeks is inserted before patients will be crossed over to placebo or active treatment at week 16.
20 studies on the registry are indexed under Dumping Syndrome; 3 are open to participants now.
This study's enrollment of 24 is below the median of 30 across 17 interventional studies indexed under Dumping Syndrome.
Browse Dumping Syndrome studies →Universitaire Ziekenhuizen KU Leuven is the lead sponsor of 963 studies on the registry; 267 are open to participants now.
Of its 5 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Patients with clinical suspect of a dumping syndrome with a total dumping score* (early and late symptoms) ≥ 10, and
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).
Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.
Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.
Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.
Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).
An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.
Childbearing potential
Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).
Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraception
Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.
Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Postmenopausal
Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Hypersensitivity
An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Patients receive lanreatide slow release (Somatuline autogel) 90 mg every four weeks via a deep subcutaneous injection, three times. After a wash out period of 4 weeks they receive a similar placebo every for weeks, three times.
Drug: Lanreotide 90 mg slow release formulation
Patients receive a deep subcutanous injection of placebo every four weeks, three times. After a wash out of three weeks, they will receive somatuline 90 mh via a deep subcutanous injection every four weeks, three times.
Drug: Placebo
Lanreotide 90 mg slow release formulation is injected deep subcutaneously, every 4 weeks, three times and compared to placebo
Also known as: Somatulin autogel
Placebo for somatuline slow release 90 mg
Change from Baseline Total Dumping score after treatment with Somatuline 90 mg and after placebo.
Early dumping starts immediately after a meal, within 1 hour (\< 1 hour). Late dumping starts later than 1 hour after a meal (≥ 1 hour). Each item is scored from zero (not present) 1 (mild) , 2 (moderate) and 3 (severe). Early dumping symptoms : sweating, flushes, dizziness, palpitations, abdominal pain, diarrhea, bloating, nausea. Late dumping symptoms : sweating, palpitations, hunger, drowsiness to unconsciousness, shaking and aggression. The change in dumping score will be assessed after 11 weeks and a second time after cross over at week 27. Additionally, the overall improvement is assessed by asking "how do you feel compared with your situation before starting the study at week 11. The same question is asked at week 27. Additionally at week 27 the following question is asked " How do you feel compared with your situation 4 months ago ?" Scoring is done on a 7 point Likert scale.
Time frame: at week 11 and week 27 during the study
Change in quality of life.
To assess the effect of Somatuline 90 mg versus placebo on a standardized quality of life questionnaire (QOL SF-36).
Time frame: week 0, 11, 16 and 27
The difference in number of participants with adverse events between somatuline 90 mg versus placebo
To assess the tolerability of Somatuline 90 mg versus placebo.
Time frame: at week 27 (end of the study)
The record gives a start of Apr 2008, a primary completion of Dec 2013 and a completion of Dec 2013. It does not say whether these dates are actual or estimated.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Jul 2017. You cannot join it, but the record below documents what was studied.
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Studies of the drug tested here: Lanreotide
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