Goltstein LCMJ, Grooteman KV, Rocco A, et al. - In most patients with red blood cell transfusion-dependent bleeding owing to gastrointestinal angiodysplasias, somatostatin analogue therapy is safe and successful. In individuals with angiodysplasias of the small bowel and colon, somatostatin analogue therapy is more successful, and octreotide therapy appears to be more effective than lanreotide therapy.

• A total of 212 patients' data were analyzed.

• During a median treatment duration of 12 months and follow-up period of 12 months, somatostatin analogues reduced the number of red blood cell transfusions with an IRR of 0·18, correlating with a mean absolute decrease in the number of red blood cell transfusions from 12·8 during baseline to 2·3 during follow-up—ie, a reduction of 10·5 red blood cell transfusions.

• Somatostatin analogue therapy was effective in 177 (83%) of 212 patients (defined as at least a 50% reduction in the number of red blood cell transfusions).

• The degree of heterogeneity among studies was moderate.

• The presence of gastrointestinal angiodysplasias in the stomach, as opposed to the small bowel and colon, was associated with worse treatment response.

• Octreotide therapy was found to be more effective than lanreotide therapy.

• The randomized controlled trial had a high level of evidence certainty, whereas the ten cohort studies had a low level of evidence certainty.

• Adverse events occurred in 38 (18%) of 212 patients receiving somatostatin analogue therapy, with ten (5%) discontinuing therapy as a result of these events.

• Loose stools, cholelithiasis, flatulence, and administration site reactions were the most common adverse events.