Vapreotide

GI / Variceal Bleeding

Also known as: Sanvar, RC-160

Somatostatin AnalogsResearch phase: Approved (some countries)Regulatory: Approved in France and some other countries for variceal bleeding. Not FDA-approved.

Mechanism

Vapreotide is a somatostatin analog used to control bleeding from esophageal varices, a dangerous complication of liver cirrhosis.

Technical detail

Vapreotide is an octapeptide somatostatin analog with high affinity for SST2 and SST5 receptors. It reduces portal venous pressure and splanchnic blood flow by inhibiting vasodilatory peptide release (glucagon, VIP). Approved in some countries for emergency management of esophageal variceal hemorrhage and as adjunct in variceal band ligation.

Evidence

  • Early administration of vapreotide for variceal bleeding in patients with cirrhosis.

    Calès et al. (2001) — N Engl J Med — PMID: 11136956

    Randomized trial in cirrhotic patients hospitalized with acute upper GI bleeding found vapreotide plus endoscopic therapy improved 5-day bleeding control versus placebo plus endoscopy (66% vs 50%), reduced active bleeding at endoscopy, and lowered transfusion requirements, without a 42-day mortality benefit.

    moderate
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