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Octreotide acetate in refractory bone marrow transplant-associated diarrhea
M A Crouch1, M S Restino, J M Cruz
1Department of Hospital Pharmacy Practice and Administration, Medical University of South Carolina, Charleston 29425, USA.
The Annals of Pharmacotherapy
|April 1, 1996
Summary
Octreotide acetate effectively reduced stool output and frequency in patients with refractory diarrhea after bone marrow transplant. Further research is needed to confirm its routine use in this patient group.
Area of Science:
- Gastroenterology
- Hematology
- Oncology
Background:
- Bone marrow transplant-associated diarrhea (BMTAD) is a common and challenging complication.
- Refractory BMTAD often requires novel therapeutic approaches.
Purpose of the Study:
- To evaluate the efficacy of octreotide acetate in managing refractory BMTAD.
- To assess the impact of octreotide acetate on stool output and frequency.
Main Methods:
- A case series study was conducted over 30 months in a bone marrow transplant unit.
- Twenty-four patients with refractory BMTAD received subcutaneous octreotide acetate (50–250 mcg 2–3 times daily).
- Treatment response was defined by a >50% reduction in stool output or frequency within 72 hours.
Main Results:
- Octreotide acetate led to complete or partial resolution of diarrhea in 82.1% of treatment challenges within 72 hours.
- Mean stool output decreased significantly from 1143 mL/d to 252 mL/d (p < 0.005).
- Mean stool frequency decreased significantly from 7.5 to 2.7 stools/day (p < 0.005).
Conclusions:
- Octreotide acetate demonstrates significant efficacy in reducing stool output and frequency in patients with refractory BMTAD.
- Adverse effects were generally mild, including injection site pain and abdominal discomfort.
- Further research is warranted to establish octreotide acetate as a standard treatment for refractory BMTAD.