Prevention of Postoperative Pancreatic Fistula by Somatostatin (PREFIPS)
Prevention of Postoperative Pancreatic Fistula by SOMATOSTATIN Compared to OCTREOTIDE: Prospective, Randomized, Controlled Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Prevention of pancreatic fistula remains a major challenge for surgeons, and various technical and pharmacological intervention have been investigated, with conflicting results.
Despite several prospective studies, and metaanalyses, the prophylactic role on pancreatic fistula of octreotide, remains controversial, even if recommended for routine use in patients undergoing pancreatic resection.
In view of recent result, the investigators can hypothesize that higher affinity for somatostatin-receptor lead to stronger pancreatic exocrine secretion inhibition, and better pancreatic fistula prevention.
Consequently, continuous intravenous infusion of somatostatin-14, the natural peptide hormone, associated with 10 to 50 time stronger affinity with all somatostatin receptor, will be associated with a improved pancreatic fistula prevention compared to octreotide.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
-
Paris, France, 75013
- La Pitié Salpêtrière Hospital
-
-
Paris
-
Paris, Paris, France, 75014
- Cochin Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Men or women aged 18 years or greater
- Signed informed consent
- Candidate for pancreaticoduodenectomy or distal pancreatectomy with or without splenectomy
Exclusion Criteria:
- Patient with radiation therapy
- Patient with neoadjuvant chemotherapy within 4 weeks before surgery
- Pregnancy
- Breastfeeding
- Patients who have any current or prior medical condition that may interfere with the conduct of the study or the evaluation of its results in the opinion of the Investigator
- Patients who have participated in any clinical investigation with an investigational drug within 1 month prior to inclusion
- Known hypersensitivity to somatostatin or somatostatin analogues or any component of the somatostatin or octreotide long-acting release (LAR) or s.c. formulations
- Patient previously treated with somatostatin or somatostatin analogues or any component of the somatostatin or octreotide LAR or s.c. formulations
- Patients treated by ciclosporin
- Patient without health insurance or social security
- Patients with a history of non-compliance to medical regimens or who are considered potentially unreliable or will be unable to complete the entire study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Somatostatin
Continuous intravenous infusion of somatostatin-14, 6 mg per day during 6.5 days
|
Lyophilisate and solution for IV use (glass ampoule of lyophilisate + 1 ml glass ampoule of solvent) 6 mg per day Continuous intravenous infusion for 6,5 days
Other Names:
|
|
Active Comparator: Octreotide
Subcutaneous octreotide 100 μg 3 times a day for 6.5 days.
|
Solution for Subcutaneous use 100μg, every 8 hours Subcutaneous injection for 6,5 days
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
≥ grade B or C postoperative pancreatic fistula as defined by the International Study Group of Pancreatic Fistula (ISGPF) classification
Time Frame: 90 days
|
90 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
≥grade 3 pancreatic complication rates (fistula, leak, and abscess)
Time Frame: 60 days
|
as defined by the MSKCC surgical secondary events system
|
60 days
|
|
Overall pancreatic fistula rate (grade A,B and C)
Time Frame: 90 days
|
previous ISGPF classification
|
90 days
|
|
Overall pancreatic fistula rate (grade B and C)
Time Frame: 90 days
|
last ISGPF classification
|
90 days
|
|
Overall complication rate (grade 1 to 5)
Time Frame: 90 days
|
according to Clavien-Dindo classification
|
90 days
|
|
Severe complication rate (grade 3 to 5)
Time Frame: 90 days
|
according to Clavien-Dindo classification
|
90 days
|
|
Mortality (grade 5)
Time Frame: 90 days
|
according to Clavien-Dindo classification
|
90 days
|
|
Overall duration of drainage
Time Frame: 90 days
|
required in patients who develop pancreatic complications (date pancreatic complication identified - date drain removed)
|
90 days
|
|
Overall length of stay
Time Frame: 90 days
|
90 days
|
|
|
Re-admission rate
Time Frame: 90 days
|
90 days
|
|
|
Cost effectiveness
Time Frame: 90 days
|
90 days
|
|
|
Fistula according to possible new definition of the ISGPF group
Time Frame: 90 days
|
90 days
|
|
|
Postoperative quality of life after pancreatic surgery
Time Frame: 7 days after surgery
|
only in patients undergoing pancreaticoduodenectomy
|
7 days after surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Sébastien GAUJOUX, MD, PhD, La Pitié Salpêtrière Hospital, AP-HP
- Study Chair: Bertrand DOUSSET, MD, PhD, Cochin Hospital, AP-HP
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathological Conditions, Anatomical
- Digestive System Diseases
- Pancreatic Diseases
- Digestive System Fistula
- Fistula
- Pathological Conditions, Signs and Symptoms
- Pancreatic Fistula
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Hypothalamic Hormones
- Peptide Hormones
- Neuropeptides
- Peptides
- Amino Acids, Peptides, and Proteins
- Nerve Tissue Proteins
- Proteins
- Polycyclic Compounds
- Macrocyclic Compounds
- Peptides, Cyclic
- Pancreatic Hormones
- Pituitary Hormone Release Inhibiting Hormones
- Octreotide
- Somatostatin
Other Study ID Numbers
Other Study ID Numbers
- P150915
- 2016-001673-32 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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