DRUG
Pasireotide
Pasireotide 0.9 mg by subcutaneous injection twice a day during 3 days and 1 intramuscular injection of pasireotide Long Acting Release (LAR) 60mg on Day 4 morning.
Status
Completed
Phase
Phase 2
Enrollment
57
Locations
14
Results
Not posted
Publications
1
Study summary
During rectal or complex digestive surgery with multiple digestive resections and anastomosis, the creation of enterostomy is a common procedure. In France, it is estimated that 20000 patients have an ileostomy and 16000 new digestive stomas are formed each year with approximately 30% of enterostomy. Enterostomy might sometimes give high-output not controlled with usual medical treatment (e.g loperamide ± codeine) and exposes the patients to important hydro-electrolytic loss leading to a risk for dehydration, electrolyte abnormalities and acute renal failure. This risk implies parenteral correction which may extend hospital stay and delay home return. Somatostatin analogues (octreotide, lanreotide and pasireotide) could reduce digestive secretions and decrease digestive peristalsis. Nevertheless, somatostatin analogues are not routinely used for the treatment of patients with high-output enterostomy and their efficacy in the indication (off-label) was only tested in small case series. Pasireotide (SOM230, SIGNIFOR®) is currently indicated for the treatment of patients with Cushing's disease for whom surgery is not an option or for whom surgery has failed. As the efficacity of pasireotide in patients with high-output enterostomy refractory to usual medical treatment associated with an oral fluid restriction has never been demonstrated before, there is a need to perform a pilot, double-blind, randomized, placebo-controlled trial evaluating its impact on reduction of the effluent volume.
Interventions
DRUG
Pasireotide 0.9 mg by subcutaneous injection twice a day during 3 days and 1 intramuscular injection of pasireotide Long Acting Release (LAR) 60mg on Day 4 morning.
DRUG
Placebo by subcutaneous injection twice a day during 3 days and 1 intramuscular injection of placebo on Day 4 morning.
Timeline
First posted
Mar 21, 2016
Study start
Dec 13, 2016
Primary completion
Jan 8, 2021
Study completion
Jan 8, 2021
Results posted
Not reported
Registry updated
Dec 19, 2025
Outcomes
Compare the efficacy of pasireotide versus placebo in reduction of high-output
Time frame · Evaluated 72 hours after first injection of treatment
Decrease of enterostomy output (ml/24H)within the 72 hours after first injection of treatment
Estimate the success rate of pasireotide and placebo
Time frame · 1 week after first injection of treatment
Number of normal renal function patients in both arms with an enterostomy output than 800 millimeters (mL) /24h within a week after first injection of treatment allowing discontinuation of intravenous perfusion.
Compare the decrease in the length of hospitalization with pasireotide versus placebo
Time frame · 1 month after the end of treatment
Duration of hospitalization in days in both arms
Compare the incidence of premature closure of stoma due to high-output with pasireotide versus placebo
Time frame · 2 months after enterostomy creation
Rate of premature closure of stoma due to high-output (before 2 months after creation) in both arms
Evaluate the economic impact of pasireotide in this indication
Time frame · 2 months from the inclusion of the patient in the study
Costs of taking care of patients from French Public Health Insurance perspective in both arms
Incidence of treatment - Emergent Adverse Events
Time frame · during treatment (4 days), one week, two weeks, three weeks and one month after treatment
Nature, number and grade of adverse events observed throughout the study
Eligibility
Inclusion Criteria: * Male and Female patients ≥ 18 years old ; * Patients who underwent an intestinal surgery with enterostomy repair in the three weeks preceding the inclusion ; * Patients with high-output ileostomy or jejunostomy \> 1000 ml/24h ; * Patients with failure of treatment combining oral fluid restriction and loperamide (up to 8 capsules/24h) +/- codeine syrup (10 mg x 3/24h) during 5 days ; * Patients who gave its written informed consent to participate to the study ; * Patients affiliated to a social insurance regime. Exclusion Criteria: * Male and Female patients \< 18 years old ; * Patients who did not give its written informed consent to participate to the study ; * Patients who received somatostatin analogues during the month before inclusion ; * Patients with symptomatic cholelithiasis or acute or chronic pancreatitis ; * Patients with uncontrolled diabetes (with HbA1c (glycated hemoglobin) \> 8%) ; * Patients who are hypothyroid and not on adequate replacement therapy ; * Patients who have congestive heart failure (NYHA (New York Heart Association) Class III or IV), unstable angina, sustained ventricular tachycardia, ventricular fibrillation, advanced heart block or a history of clinically significant bradycardia or acute myocardial infarction within the 6 months preceding randomization ; * Patients with history of syncope or family history of idiopathic sudden death ; * Patients with screening or baseline (predose) : QT interval corrected for heart rate using Fridericia's correction (QTcF) QTcF \> 450 msec (male), QTcF \> 460 msec (female) (QT interval corrected for heart rate using Fridericia's correction) ; * Patients with not corrected hypokalaemia and/or hypomagnesaemia ; * Patients with liver disease such as cirrhosis, chronic active hepatitis, or chronic persistent hepatitis, or patients with alanine transaminase/aspartate transaminase (ALT/AST) \> 2 x Upper Limit of Normal (ULN), serum bilirubin \> 2 x ULN ; * Patients with Child-Pugh C cirrhosis ; * Female patients who are pregnant or lactating, or are of childbearing potential and not practicing a medically acceptable method of birth control ; * Patients with abnormal coagulation (PT and/or APTT elevated by 30% above normal limits) or patients receiving anticoagulants that affect PT (prothrombin time) or activated partial thromboplastin time (APTT) ; * Patients with known hypersensitivity to somatostatin analogues or any other component of the pasireotide LAR ; * Patients under guardianship ; * Patients nonaffiliated to a social insurance regime.
Study locations
France. Showing up to 24 locations stored in the fast local snapshot.
Chu Amiens-Picardie
Amiens, France
Chu Estaing
Clermont-Ferrand, France
Hopital Beaujon
Clichy, France
Chu Albert Michallon
La Tronche, France
Hôpital Claude HURIEZ - CHRU Lille
Lille, France
Centre Leon Berard
Lyon, France
Chu Marseille - Hopital Nord
Marseille, France
Institut Regional Du Cancer Val D'Aurelle
Montpellier, France
Chu Caremeau
Nîmes, France
Hopital Saint Antoine
Paris, France
Bordeaux Chu - Hopital Haut-Leveque
Pessac, France
Centre Hospitalier Lyon Sud
Pierre-Bénite, France
Chu Rouen Ch. Nicolle
Rouen, France
Toulouse - Chu Purpan
Toulouse, France
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