Effect of Octreotide on Refractory AIDS-associated Diarrhea

摘要: Objective To determine the efficacy and safety of octreotide for treatment refractory, profuse diarrhea in patients with acquired immunodeficiency syndrome (AIDS). Design A prospective, open-label study. Setting Inpatient metabolic units four university medical centers. Patients Fifty-one infected human virus (HIV) who had uncontrolled (greater than or equal to 500-mL liquid stool per day) despite maximally tolerable doses antidiarrheal medications. Intervention After initial baseline studies, received octreotide, 50 micrograms every 8 hours 48 hours. If volume was not reduced less 250 mL/d, dose increased stepwise 100, 250, 500 micrograms. Main results Fifty men one woman (mean age, 36.3 +/- 1.1 years) entered completed 28-day protocol (14 days inpatient therapy 14 outpatient therapy). Stool frequency decreased significantly (6.5 0.5 stools day on 0 compared 3.8 0.3 21 [P 0.001] 1604 180 mL/d 1084 162 0.001], respectively). Twenty-one (41.2%) were considered be partial complete responders (reduction daily by greater 50% collections reduction mL/d). Of responders, (67%) no identifiable pathogens at screening 9 30 (30%) nonresponders (P 0.01). Conclusion AIDS-associated refractory watery diarrhea, especially those without pathogens, may respond favorably subcutaneously administered octreotide. This drug deserves further study a randomized, placebo-controlled trial.