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Recurrent bleeding from gastrointestinal angiodysplasias occurs in as many as one third of patients within 2 years of endoscopic argon-plasma coagulation (APC). In this open-label randomized trial from the Netherlands, 62 patients (mean age, 72) with angiodysplasias and transfusion-dependent anemia received 40 mg of intramuscular octreotide every 28 days or usual care (i.e., as-needed transfusions of iron or blood) for 1 year; all patients had undergone APC at least once previously. Patients in either group could undergo endoscopy and APC if treating clinicians deemed it necessary, but antiangiogenic medications (thalidomide or bevacizumab) were not allowed.
Patients had angiodysplasias in the small intestine (87%), colon (48%), and stomach …