Diarrhea and the rationale to use Sandostatin®

This paper reviews the research that has been conducted into the use of Sandostatin® to control the debilitating symptoms of diarrhea in a number of different etiologies. These are cancer- related diarrheas, including diarrhea related to chemotherapy, radiotherapy, neuroendocrine tumor carcinoid syndrome, vaso- active intestinal peptide-secreting tumors and also non-cancer related diarrhea, including short bowel syndrome, ileo- and jejunostomy, dumping syndrome, graft versus host disease and AIDS-related diarrhea. There is an increasing recognition of the need to balance the cost of care with patient outcome. It is becoming clear that although the cost of a therapeutic regimen with Sandostatin® is substantially greater than the current non-specific therapy, the overall cost is potentially greater without the use of Sandostatin® for patients with refractory diarrhea due to the inevitable need for further treatment and/or hospitalization with intravenous fluid supple- mentation. Initial trials and reports from preclinical testing and clinical practice have shown promising results and, although in the major- ity of cases they strengthen the view taken in the published consen- sus guidelines for the use of Sandostatin® for refractory diarrhea, further, larger scale, comparative clinical trials are required for any evidence-based definition of dosage and efficacy as a treatment or prophylactic agent to combat and control diarrhea. (Acta gastro- enterol. belg., 2010, 73, 25-36).