Single dose secretin no more effective than placebo for autism

Secretin, a hormone reported to be useful in the treatment of autism, is no more effective than placebo, according to Dr Adrian Sandler (Olson Huff centre for child development, Asheville, North Carolina, US) and colleagues.

Reporting in the New England Journal of Medicine (1999;341:1801), they describe a trial of 60 children with autism (56 completed the study), who were given a single intravenous infusion of either secretin or saline. The effect of each treatment was compared by use of 16 behavioural assessments at several time points.

Secretin was not associated with significantly greater improvements than placebo in any of the outcome measures, the researchers report. For six of the 16 outcomes, treatment with both placebo and secretin resulted in some improvement but there was no difference in magnitude of these improvements between the two groups.

The authors comment that weaknesses of the study include the fact that it only measured outcomes in the short-term and that only a single dose was given; multiple doses may prove more efficacious, they say. In addition, a synthetic form of secretin was used while anecdotal reports of successful secretin use have been based on administration of the porcine product. Reports have also claimed that secretin improves the symptoms of autism after one dose.

Despite the outcome of the trial, 69 per cent of parents whose children were trial participants said that they remained interested in secretin as a form of treatment for their child’s autism. In an accompanying editorial, Dr Fred Volkmar (Yale University school of medicine, Connecticut) says that lessons must be learnt from the “secretin phenomenon”. Extensive media coverage before data supporting its use were available was “premature and unfortunate” (ibid p1843).