Octreotide treatment of carcinoid syndrome: analysis of published dose-titration data.

Abstract

BACKGROUND:

Octreotide has proven therapeutically effective in carcinoid syndrome, but the rarity of carcinoid tumors has hampered detailed dose-ranging studies. This study analysed published dose-titration data on octreotide use in carcinoid patients to (a) investigate the relation between octreotide dose and efficacy and (b) establish octreotide dosing recommendations for maximum therapeutic benefit.

METHOD:

An exhaustive, computer-assisted literature search for published articles employing octreotide to manage patients with carcinoid syndrome was performed using several databases. The relation between octreotide dose and efficacy in decreasing urinary 5-hydroxyindoleacetic acid (5-HIAA) levels, flushing and diarrhoea was analysed for seven dose ranges by pooling data from selected articles.

RESULTS:

Analysis of data compiled from 62 published studies revealed that maximum effective therapeutic doses of octreotide effectively controlled symptoms in up to 93% of patients, and that increasing the dose of octreotide is associated with increased benefit with respect to control of flushing, diarrhoea and 5-HIAA levels.

CONCLUSIONS:

We recommend starting octreotide therapy at 100 micrograms subcutaneously t.d.s. in patients with mild/moderate, non-life-threatening carcinoid syndrome. Since therapeutic response to octreotide varies markedly among patients, we recommend titrating the octreotide dose in increments of 50-100 micrograms every 8 h until adequate symptom control is achieved.

• Authors: A G Harris, J S Redfern
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 9 Issue 4 Pg. 387-94 (Aug 1995) ISSN: 0269-2813 [Print] England
• PMID: 8527614 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Octreotide

Topics

• Carcinoid Tumor (drug therapy)
• Diarrhea (chemically induced)
• Dose-Response Relationship, Drug
• Flushing (chemically induced)
• Follow-Up Studies
• Humans
• Octreotide (therapeutic use)
• Statistics as Topic