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Previous Volume 341:1801-1806 December 9, 1999 Number 24 Next

	Full Text PDF Editorial by Volkmar, F. R. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Secretin is a peptide hormone that stimulates pancreatic secretion. After recent publicity about a child with autism whose condition markedly improved after a single dose of secretin, thousands of children with autistic disorders may have received secretin injections.

Methods We conducted a double-blind, placebo-controlled trial of a single intravenous dose of synthetic human secretin in 60 children (age, 3 to 14 years) with autism or pervasive developmental disorder. The children were randomly assigned to treatment with an intravenous infusion of synthetic human secretin (0.4 µg per kilogram of body weight) or saline placebo. We used standardized behavioral measures of the primary and secondary features of autism, including the Autism Behavior Checklist, to assess the degree of impairment at base line and over the course of a four-week period after treatment.

Results Of the 60 children, 4 could not be evaluated — 2 received secretin outside the study, and 2 did not return for follow-up. Thus, 56 children (28 in each group) completed the study. As compared with placebo, secretin treatment was not associated with significant improvements in any of the outcome measures. Among the children in the secretin group, the mean total score on the Autism Behavior Checklist at base line was 59.0 (range of possible values, 0 to 158, with a larger value corresponding to greater impairment), and among those in the placebo group it was 63.2. The mean decreases in scores over the four-week period were 8.9 in the secretin group and 17.8 in the placebo group (mean difference, –8.9; 95 percent confidence interval, –19.4 to 1.6; P=0.11). None of the children had treatment-limiting adverse effects. After they were told the results, 69 percent of the parents of the children in this study said they remained interested in secretin as a treatment for their children.

Conclusions A single dose of synthetic human secretin is not an effective treatment for autism or pervasive developmental disorder.

Source Information

From the Olson Huff Center for Child Development, Thoms Rehabilitation Hospital, Asheville, N.C. (A.D.S., J.D., M.A.G., V.S.); the Human Development Research and Training Institute, Western Carolina Center, Morganton, N.C. (K.A.S., J.W.B.); and the Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (J.W.B.).

Address reprint requests to Dr. Sandler at the Olson Huff Center for Child Development, Thoms Rehabilitation Hospital, 68 Sweeten Creek Rd., Asheville, NC 28803, or at adsandler{at}pol.net.

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