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Review
. 2021 Sep 24;16(9):e0257606.
doi: 10.1371/journal.pone.0257606. eCollection 2021.

Somatostatin analog therapy effectiveness on the progression of polycystic kidney and liver disease: A systematic review and meta-analysis of randomized clinical trials

Tatsuya Suwabe  1   2 , Francisco J Barrera  3   4 , Rene Rodriguez-Gutierrez  3   4 , Yoshifumi Ubara  1   2 , Marie C Hogan  5
Affiliations
Review

Somatostatin analog therapy effectiveness on the progression of polycystic kidney and liver disease: A systematic review and meta-analysis of randomized clinical trials

Tatsuya Suwabe et al. PLoS One. .

Abstract

Background: Uncertainty underlies the effectiveness of somatostatin analogues for slowing the progression of polycystic kidney or liver disease.

Methods: Eligible studies included randomized controlled trials (RCTs) evaluating somatostatin analog as therapy for patients with polycystic kidney disease (PKD) or polycystic liver disease (PLD) compared to placebo or standard therapy. Two reviewers independently screened studies identified from databases (MEDLINE, EMBASE, Cochrane Database), clinical trial registries, and references from pertinent articles and clinical practice guidelines. Outcome measurements were changes in total liver volume (TLV), total kidney volume (TKV), and estimated glomerular filtration rate (eGFR).

Results: Of 264 nonduplicate studies screened, 10 RCTs met the inclusion criteria. The body of evidence provided estimates warranting moderate confidence. Meta-analysis of 7 RCTs including a total of 652 patients showed that somatostatin analogs are associated with a lower %TLV growth rate compared to control (mean difference, -6.37%; 95% CI -7.90 to -4.84, p<0.00001), and with a lower %TKV growth rate compared to control (mean difference, -3.66%; 95% CI -5.35 to -1.97, p<0.0001). However, it was not associated with a difference in eGFR decline (mean difference, -0.96 mL/min./1.73m2; 95% CI -2.38 to 0.46, p = 0.19).

Conclusions: Current body of evidence suggests that somatostatin analogs therapy slows the increase rate of TLV and TKV in patients with PKD or PLD compared to control within a 3-year follow-up period. It does not seem to have an effect on the change in eGFR. Somatostatin analogs therapy can be a promising treatment for ADPKD or ADPLD, and we need to continue to research its effectiveness for ADPKD or ADPLD.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Process of study selection.
Fig 2
Fig 2. Meta-analysis of TLV.
Fig 3
Fig 3. Meta-analysis of TKV.
Fig 4
Fig 4. eGFR.
See this image and copyright information in PMC

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Grants and funding

This work was supported by JSPS KAKENHI in the form of a grant awarded to TS (JP19K17758) and in part by the Ministry of Health, Labour and Welfare of Japan in the form of a Grant-in-Aid for Progressive Renal Disease Research and Okinaka Memorial Institute for Medical Research, Toranomon Hospital in the form of funds awarded to TS.