Healthcare and economic impact of diarrhea in patients with carcinoid syndrome

Broder, Michael S.; Chang, Eunice; Romanus, Dorothy; Cherepanov, Dasha; Neary, Maureen P.

doi:10.3748/wjg.v22.i6.2118

Cited by 32 publications

(25 citation statements)

References 25 publications

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“…The total costs per patient per year associated with medical and surgical interventions, examinations and imaging, outpatient visits, inpatient admissions, chemotherapy and other diarrhoea therapies were lower in the world-with TE scenario. This is in accordance with other studies showing that patients with CS who experience flushing and diarrhoea symptoms incur around $US14,766-29,890 more per year in healthcare costs than those experiencing improvements in symptoms [10,56].…”

Section: Discussionsupporting

confidence: 93%

“…CS develops most commonly in patients with small intestinal NETs and hepatic metastases [3,6] and less commonly in patients with pancreatic tumours or lung NETs; CS can also occur when secretions drain directly from tumours into the central circulation [3,[7][8][9]. Approximately 6-19% of patients with NETs will develop CS [1][2][3]10], and 20-50% of patients with CS develop carcinoid heart disease (CaHD) [11]. In CaHD, secretion of serotonin and other vasoactive substances can cause the deposition of plaques on the right side of the heart, leading to right heart valve dysfunction and possible heart failure [12].…”

Section: Introductionmentioning

confidence: 99%

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A Budget Impact Model of the Addition of Telotristat Ethyl Treatment to the Standard of Care in Patients with Uncontrolled Carcinoid Syndrome

Fust

Maschio²,

Kohli³

et al. 2020

PharmacoEconomics

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Background Carcinoid syndrome, a rare condition in patients with neuroendocrine tumours, characterised by flushing and diarrhoea, severely affects patients' quality of life. The current carcinoid syndrome standard of care includes somatostatin analogues, but some patients experience uncontrolled symptoms despite somatostatin analogue therapy. Telotristat ethyl is a novel treatment approved by the European Medicines Agency (EMA) and US FDA that significantly reduces bowel movement frequency in patients with uncontrolled carcinoid syndrome.Objective We developed a model to evaluate the 5-year budget impact of introducing telotristat ethyl to standard care in Swedish patients with uncontrolled carcinoid syndrome. Methods Treatment response in the 12-week phase III TELESTAR trial (NCT01677910) informed telotristat ethyl efficacy; subsequently, health states were captured by a Markov model using 4-week cycles. TELESTAR open-label extension data informed telotristat ethyl discontinuation. The number of treatment-eligible patients was estimated from literature reviews reporting the prevalence, incidence and mortality of carcinoid syndrome. A Swedish database study informed real-world costs related to carcinoid syndrome and carcinoid heart disease costs. Telotristat ethyl market share was assumed to increase annually from 24% (year 1) to 70% (year 5). Results Over the 5-year model horizon, 44 patients were expected to initiate telotristat ethyl treatment. The cumulative net budget impact of adding telotristat ethyl to current standard of care was €172,346; per-year costs decreased from €66,495 (year 1) to €29,818 (year 5). Increased drug costs from adding telotristat ethyl were offset by reduced costs elsewhere. Conclusions The expected budget impact of adding telotristat ethyl to the standard of care in Sweden was relatively low, largely because of the rarity of carcinoid syndrome.Electronic supplementary material The online version of this article (https ://doi.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

A Budget Impact Model of the Addition of Telotristat Ethyl Treatment to the Standard of Care in Patients with Uncontrolled Carcinoid Syndrome

Fust

Maschio²,

Kohli³

et al. 2020

PharmacoEconomics

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“…Carcinoid syndrome (CS) is known to cause significant clinical morbidity with substantial effects on quality of life . Patients with carcinoid syndrome diarrhea (CSD) require more medical care and have more hospitalizations and higher health care costs than their peers without CSD . The prevalence of pretreatment CS symptoms among patients enrolled in a recent phase III clinical trial was considerable, including bowel movement‐related issues (97%), flushing (86%), and abdominal pain (63%) .…”

Section: Introductionmentioning

confidence: 99%

TELEPRO: Patient-Reported Carcinoid Syndrome Symptom Improvement Following Initiation of Telotristat Ethyl in the Real World

et al. 2019

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“…The annual number of shigellosis episodes throughout the world is estimated to be 164.7 million, with 69% of all episodes and 61% of all deaths attributable to shigellosis involving children <5 years of age . The economic impact of diarrhea and its treatment are of considerable importance . The annual treatment costs for diarrhea are very high and ranged from US$ 907 116 to US$ 1 851 280 for ambulatory clinical consultations and from US$ 701 833 to US$ 4 581 213 for hospitalizations .…”

Section: Introductionmentioning

confidence: 99%

“…10 The economic impact of diarrhea and its treatment are of considerable importance. 14,15 The annual treatment costs for diarrhea are very high and ranged from US$ 907 116 to US$ 1 851 280 for ambulatory clinical consultations and from US$ 701 833 to US$ 4 581 213 for hospitalizations. 16 The re-emergence of Shigella dysenteriae type 1 (Sd1) with added resistance to ciprofloxacin, which has epidemic potential, has also been reported.…”

mentioning

confidence: 99%

Effects ofOxalis barrelieriL. (Oxalidaceae) aqueous extract on diarrhea induced byShigella dysenteriaetype 1 in rats

Tagne

Noubissi

Fankem

et al. 2017

Health Science Reports

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Aim: Oxalis barrelieri is a medicinal plant commonly used in Cameroon, for the treatment of many diarrheal diseases. The antibacterial properties of O barrelieri aqueous extract (WOb) against Shigella dysenteriae type 1 were investigated in vitro and in vivo.Methods: Antibacterial activity was evaluated in vitro by disc diffusion method and by macrodilution method. S dysenteriae type 1 at a dose of 1.2 × 10 9 CFU was administrated orally to rats to induce shigellosis. For 6 consecutive days, diarrheic rats were treated with O barrelieri aqueous extract (50 and 100 mg/kg BW) or norfloxacin (20 mg/kg BW). The diarrheal stool weight and S dysenteriae type 1 density were assessed during the treatment period, and death rate recorded. Nitric oxide production in blood and in colonic homogenate and blood parameterswere assessed, and the histological section of the colon was performed in the survivors. Results:The minimal inhibitory concentration and minimal bactericidal concentration of WOb were, respectively, 6 mg/mL and 25 mg/mL. The mean minimal bactericidal concentration/minimal inhibitory concentration ratio for WOb against S dysenteriae type 1 was high (˃4); WOb could be classified as a bacteriostatic drug. WOb significantly (P < .01) reduced bacterial density and diarrheal stool weight. WOb decreased nitric oxide production (P < .01) in the large intestine and protected the mucosa of the colon from bacterial destruction. Conclusion:The results suggest that O barrelieri aqueous extract possesses bacteriostatic and antidiarrheal activities and reduces damages caused to intestinal mucosa barrier by pathogenic mechanisms of Shigella. This extract could be used as an alternative therapeutic for infectious diarrhea. KEYWORDSantibacterial susceptibility, antidiarrheal activity, Oxalis barrelieri, rat, Shigella dysenteriae type 1 | INTRODUCTIONIn mammals, the gastrointestinal tract harbors various microbes that play an essential role in maintaining its physiological homeostasis. ------------------------------------------------------------------This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Healthcare and economic impact of diarrhea in patients with carcinoid syndrome

Abstract: Diarrhea is burdensome and costly in CS patients. Reduction of CS-related healthcare expenditures may be achievable through preventive treatment and appropriate management of diarrhea in CS.

Cited by 32 publications

References 25 publications

A Budget Impact Model of the Addition of Telotristat Ethyl Treatment to the Standard of Care in Patients with Uncontrolled Carcinoid Syndrome

A Budget Impact Model of the Addition of Telotristat Ethyl Treatment to the Standard of Care in Patients with Uncontrolled Carcinoid Syndrome

TELEPRO: Patient-Reported Carcinoid Syndrome Symptom Improvement Following Initiation of Telotristat Ethyl in the Real World

Effects ofOxalis barrelieriL. (Oxalidaceae) aqueous extract on diarrhea induced byShigella dysenteriaetype 1 in rats

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