From the Guidelines
Secretin is not recommended for the treatment of autism spectrum disorder (ASD). The use of secretin, a gastrointestinal hormone, has been repeatedly shown to have no benefit in improving the core symptoms of autism, including social interaction, communication skills, or repetitive behaviors 1. Despite initial interest stemming from observations of behavioral improvements in some children with autism after receiving secretin during diagnostic gastrointestinal procedures, subsequent randomized controlled trials have failed to demonstrate any significant improvement compared to placebo.
The current evidence-based approaches for autism management include:
- Behavioral therapies, such as Applied Behavior Analysis
- Speech and occupational therapy
- Medications that target specific symptoms like irritability or attention issues These established interventions have proven efficacy and should be the focus of parents and caregivers rather than pursuing secretin treatment, which lacks scientific support and may unnecessarily divert resources from more effective therapies 1.
It is essential for clinicians to be aware of the use of alternative or complementary treatments, including secretin, and to discuss their risks and potential benefits with parents, recognizing the motivation for parents to seek all possible treatments 1. However, in the case of secretin, the lack of empirical support and the availability of more effective therapies make it an unsuitable treatment option for autism spectrum disorder.
From the Research
Secretin for Autism
- Secretin, a gastrointestinal hormone, has been studied as a potential treatment for autism spectrum disorders (ASD) based on anecdotal evidence 2, 3, 4, 5, 6.
- Multiple randomized controlled trials have been conducted to assess the efficacy of intravenous secretin in improving core features of autism, communication, behavior, and quality of life 2, 3, 4, 5, 6.
- The results of these studies have consistently shown that secretin is not effective in improving the symptoms of ASD, including language and communication impairment, symptom severity, and cognitive and social skill deficits 2, 3, 4, 5, 6.
- A systematic review of 7 randomized controlled trials found that secretin lacked benefit for the treatment of ASD symptoms, and no studies resulted in significantly greater improvements in measures of language, cognition, or autistic symptoms when compared with placebo 4.
- Another review of 17 studies, including 12 placebo-controlled studies, found that secretin failed to demonstrate differential efficacy in 12 of the 13 placebo-controlled studies 5.
- A double-blind, placebo-controlled trial of a single intravenous dose of synthetic human secretin in 60 children with autism or pervasive developmental disorder found no significant improvements in any of the outcome measures 6.
Outcome Measures
- Standardized outcome measures, such as the Childhood Autism Rating Scale, Autism Behavior Checklist, and measures of language, cognition, and social skills, have been used to assess the efficacy of secretin in ASD treatment 2, 3, 4, 5, 6.
- These measures have consistently shown no significant improvements in ASD symptoms with secretin treatment compared to placebo 2, 3, 4, 5, 6.
Recommendations
- Based on the lack of evidence supporting the efficacy of secretin in ASD treatment, it is not recommended as a treatment for autism 2, 3, 4, 5, 6.
- Further experimental assessment of secretin's effectiveness for ASD can only be justified if there is new high-quality and replicated scientific evidence that either finds that secretin has a role in neurotransmission in a way that could benefit all children with ASD or identifies important subgroups of children with ASD who could benefit from secretin 3.