Octreotide treatment in secretory and cyrptosporidial diarrhea in patients with acquired immunodeficiency syndrome (AIDS): clinical evaluation.

Abstract

Our objective was to evaluate the efficacy of octreotide in the treatment of AIDS patients with persistent diarrhea refractory to conventional therapy. We have treated 11 patients with AIDS related diarrhea (M/F-5/2, mean age 28 +/- 3 yr). The stool volume was in all pts > or = 21/24h. In 4 pts the diarrhea was secondary to cryptosporidium infection (Group A); in 7 pts the reason for the diarrhea could not be identified (Group B). Octreotide was administered in subcutaneous escalation doses, from 50 micrograms q8h to a maximum dose of 500 micrograms q8h. The minimal dose controlling symptoms was maintained for 21 days. In all patients stool volume and frequency decreased significantly. Group A pts were "partial responders" (stool 50% of initial daily volume); group B patients were "complete responders" (stools < 250-300 ml/day). Drug suspension resulted in a prompt return of diarrhea, especially in group A and in these patients, the cryptosporidium was continuously eliminated in the stool. With octreotide therapy there was a reduction in stool volume and frequency; whether this treatment is effective as long-term therapy for this AIDS manifestation is unknown.