A Systematic Review of Secretin for Children With Autism Spectrum Disorders

The journal Pediatrics has a series of articles out recently on autism therapies. All are review articles: discussions of previous papers rather than new research. One topic that was covered was secretin. I don’t hear much about secretin now, but it was a big event in the 1990’s. Last I checked (which was some time ago) many alternative medical practitioners in the Defeat Autism Now group still were prescribing it. The Autism Research Institute’s webpage still has a prominent link to “The Use of Secretin in Autism: Some Preliminary Answers “, an article from 1998.

A number of studies have been performed on the use of secretin, including randomized control trials (RCT). There is enough data that the authors of this review were able to make a rather definitive statment: not only is there no evidence of having an imact.

CONTEXT: As many as 1 in every 110 children in the United States has an autism spectrum disorder (ASD). Secretin is 1 of many medical treatments studied for treating the symptoms of ASDs, but there is currently no consensus regarding which interventions are most effective.
OBJECTIVE: To systematically review evidence regarding the use of secretin in children with ASDs who are aged 12 years and younger. METHODS: We searched the Medline, PsycINFO, and ERIC (Education Resources Information Center) databases from 2000 to May 2010 and reference lists of included articles. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Two reviewers independently extracted data regarding participant and intervention characteristics, assessment techniques, and outcomes and assigned overall quality and strength-of-evidence ratings on the basis of predetermined criteria.
RESULTS: Evidence from 7 randomized controlled trials supports a lack of effectiveness of secretin for the treatment of ASD symptoms including language and communication impairment, symptom severity, and cognitive and social skill deficits. No studies have resulted in significantly greater improvements in measures of language, cognition, or autistic symptoms when compared with placebo; study authors who reported improvement over time did so equally for both the intervention and placebo groups.
CONCLUSIONS: Secretin has been studied extensively in multiple randomized controlled trials, and there is clear evidence that it lacks benefit. The studies of secretin included in this review uniformly point to a lack of significant impact of secretin in the treatment of ASD symptoms. Given the high strength of evidence for a lack of effectiveness, secretin as a treatment approach for ASDs warrants no further study.

Here is the conclusion of the paper:

Previous studies have demonstrated that secretin is not effective for improving language, cognition, behavior, communication, autism symptom severity, or socialization skills. The strength of evidence for this lack of effectiveness is high. With 7 randomized controlled trials with fair- to good quality scores and 1 case series that contributes to this evidence base, future studies are unlikely to change the estimate of effect for this treatment. Further studies of secretin in children with ASDs are not warranted.

This is pretty strong: “Further studies of secretin in children with ASDs are not warranted”