{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:18:35Z","timestamp":1783487915318,"version":"3.55.0"},"reference-count":17,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"This work was supported by the Italian Ministry of Health, Rome, Italy (Ricerca Corrente).","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Background: Portal hypertension can lead to complications such as ascites, hepatic encephalopathy, esophageal varices, and gastrointestinal (GI) bleeding, all of which are associated with significant morbidity and mortality. Variceal bleeding is the most severe complication, with an estimated mortality of up to 30%. In children, evidence-based guidelines for the management of GI bleeding secondary to portal hypertension are lacking. In this con-text, octreotide, a synthetic somatostatin analog approved for other indications, has been increasingly used off-label and represents a paradigmatic example of drug re-purposing in pediatrics. Methods: Following the 2020 PRISMA guidelines, this systematic review evaluated the efficacy and safety of octreotide for the treatment of portal hyperten-sion-related GI bleeding in children. A comprehensive search of six sources, including five bibliographic databases (PubMed, Embase, Web of Science, Cochrane Library, and EBSCOhost) and the ClinicalTrials.gov registry, was conducted to identify studies in-cluding pediatric patients with GI bleeding secondary to portal hypertension. Results: Three non-randomized observational studies were included, assessing bleeding recurrence, packed red blood cell requirements, and adverse events following octreotide admin-istration. Overall, 33 patients were analyzed, with a mean age of 6.3 years. One study reported a reduction in rebleeding episodes and transfusion requirements after oc-treotide treatment. Across all included studies, no serious adverse events were ob-served; mild and reversible hyperglycemia was the only reported drug-related effect. Quantitative synthesis was not feasible due to substantial heterogeneity, missing data, and a serious risk of bias, resulting in very low certainty of evidence. Conclusions: Octreotide may represent a feasible therapeutic option for portal hypertension-related GI bleeding in children; however, further prospective and standardized studies are needed to establish its long-term safety and efficacy.<\/jats:p>","DOI":"10.3390\/ph19070978","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T03:06:34Z","timestamp":1782875194000},"page":"978","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Octreotide for Gastrointestinal Bleeding Due to Portal Hypertension in Children\u2014A Systematic Review"],"prefix":"10.3390","volume":"19","author":[{"given":"Ann","family":"Kozak","sequence":"first","affiliation":[{"name":"Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA 15261, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Nolder","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA 15261, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5895-7257","authenticated-orcid":false,"given":"Giusy","family":"Ranucci","sequence":"additional","affiliation":[{"name":"IRCCS ISMETT, 90127 Palermo, Italy"},{"name":"UPMC Italy, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7132-000X","authenticated-orcid":false,"given":"Alessio","family":"Provenzani","sequence":"additional","affiliation":[{"name":"IRCCS ISMETT, 90127 Palermo, Italy"},{"name":"UPMC Italy, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1111\/j.1939-1676.2011.00691.x","article-title":"Portal hypertension: Pathophysiology, diagnosis, and treatment","volume":"25","author":"Buob","year":"2011","journal-title":"J. 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Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"87","DOI":"10.4103\/1319-3767.93807","article-title":"Therapeutic applications of octreotide in pediatric patients","volume":"18","author":"Butzner","year":"2012","journal-title":"Saudi J. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1590\/S0103-05822011000400021","article-title":"Octreotide for acute gastrointestinal bleeding secondary to portal hypertension in pediatric patients: Experience of a tertiary center","volume":"29","author":"Meneses","year":"2011","journal-title":"Rev. Paul. Pediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1111\/j.1399-3046.2012.01652.x","article-title":"Portal hypertension in children: Expert pediatric opinion on the report of the Baveno v Consensus Workshop on Methodology of Diagnosis and Therapy in Portal Hypertension","volume":"16","author":"Shneider","year":"2012","journal-title":"Pediatr. Transplant."}],"container-title":["Pharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8247\/19\/7\/978\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:52:23Z","timestamp":1783486343000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8247\/19\/7\/978"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,24]]},"references-count":17,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["ph19070978"],"URL":"https:\/\/doi.org\/10.3390\/ph19070978","relation":{},"ISSN":["1424-8247"],"issn-type":[{"value":"1424-8247","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,24]]}}}