PD321 - OCTREOTIDE AS AN ADDITIVE IN LIPID CONTAINING PARENTERAL NUTRITION

PD321

OCTREOTIDE AS AN ADDITIVE IN LIPID CONTAINING PARENTERAL NUTRITION

M. Banks^1,*, S. Asimes¹, K. Condo¹, K. Munroe¹, S. Paski¹

¹Center for Gut Rehabilitation and Transplant, Cleveland Clinic , Cleveland , United States

Rationale: Octreotide, a synthetic somatostatin analogue (SSA), is an anti-secretory therapy that may be added to Parenteral Nutrition (PN). For 3:1 lipid containing PN solutions with added SSA, soy-based lipids have in-vitro evidence of stability but reduced activity by 48 hours. Manufacturers report compatibility (no bioavailability) testing for olive-oil based lipids. Stability or bioavailability data for SSA in mixed fish oil lipids (MO) 3:1 PN are not available limiting home PN use in the U.S. This study compared adverse events (AE) of SSA added to 3:1 PN with MO compared to Alternative Lipids (AL) (soy and olive-oil based lipid emulsions).

Methods: This is a retrospective cohort study of 314 home PN episodes from 1/2018-7/2024 where SSA was added to PN with MO or AL. No power calculation due to lack of data. AE included catheter-associated deep vein thrombosis, catheter occlusion, malfunction or breakage, and physical incompatibility of PN. Alteplase use for partial occlusions was recorded. Wilcoxon rank-sum (continuous) and Pearson’s Chi-square or Fisher’s exact tests (categorical) were used. Incidence rates per 1,000 catheter-days were modeled with Poisson and negative binomial mixed-effects models (offset log catheter-days; random patient effect), reporting adjusted IRRs with 95% CIs.

Results: There were 257 AL and 57 MO episodes. Main indications for SSA were high ostomy output or diarrhea (55.4%). MO was not associated with catheter removal due to complete or partial occlusion or breakage vs. AL (IRR = 0.79; 95% CI: 0.31–2.02; p = 0.62). Alteplase use was lower among MO vs. AL (IRR = 0.18; 95% CI: 0.04–0.70; p = 0.014). No physical incompatibility events were reported.

Conclusion: SSA in 3:1 PN with MO was not associated with higher rates of catheter-related AE compared to AL; no physical incompatibility events were observed. Prospective studies are needed to confirm compatibility and clinical outcomes of SSA with MO in 3:1 PN.

Disclosure of Interest: M. Banks: None declared, S. Asimes: None declared, K. Condo: None declared, K. Munroe: None declared, S. Paski Other: Consultation for Nutrishare, Advisory Board