Incident Gallstones During Somatostatin Analog Treatment are Associated with Acute Biliary Complications Especially After Discontinuation

DIPAK Consortium, Sophie E Aapkes, Robbert J de Haas, Lucas H P Bernts, Charles J Blijdorp, Sosha E I Dekker, Maatje D A van Gastel, Esther Meijer, Abigail Veldman, Joost P H Drenth, Ron T Gansevoort*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

INTRODUCTION: Gallstones are a known adverse effect of somatostatin analogs, but the exact incidence and clinical implications are unknown.

OBJECTIVES: The aim of this study was to investigate the incidence of gallstones on imaging and related complications in unbiased trial data.

METHODS: Data from the DIPAK 1 trial, in which 305 polycystic kidney disease patients were randomized to standard of care (SoC) or lanreotide for 120 weeks, were used. Magnetic resonance imaging (MRI) was performed at baseline and end of treatment and was assessed for the presence, number, and size of gallstones. For all patients who had gallstones at the end of the trial, we obtained follow-up after the trial.

RESULTS: Of 249 patients with data available, 11 patients randomized to lanreotide and four randomized to SoC had gallstones at baseline. During the study, new gallstones were formed in 19/124 patients using lanreotide (15%) and 1/125 patients receiving SoC (1%). The odds ratio for gallstone formation with lanreotide use was 25.9 (95% confidence interval 3.37-198.8; p < 0.001). Gallstones during lanreotide treatment were multiple (> 20 stones in 69% of patients) and small (≤ 3 mm in 63% of patients). Of the 19 patients with incident gallstones during lanreotide treatment, 9 experienced gallstone-associated complications, 8 of whom experienced gallstone-associated complications after discontinuation of treatment (median time after discontinuation 2.5 years). In patients with gallstones at baseline and in patients receiving SoC, no complications occurred.

CONCLUSIONS: Treatment with a somatostatin analog leads to the formation of multiple, small gallstones that are associated with severe complications, especially after discontinuation of therapy.

CLINICAL TRIAL REGISTRY WEBSITE AND TRIAL NUMBER: ClinicalTrials.gov ( https://clinicaltrials.gov ); NCT01616927.

Original languageEnglish
Pages (from-to)179-188
Number of pages10
JournalDrugs in R&D
Volume21
Issue number2
Early online date29-Mar-2021
DOIs
Publication statusPublished - Jun-2021

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