Drug updated on 3/28/2024
| Dosage Form | Tablet (oral: 250 mg) |
| Drug Class | Tryptophan hydroxylase inhibitors |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- For the treatment of carcinoid syndrome diarrhea in combination with somatostatin analog (SSA) therapy in adults inadequately controlled by SSA therapy.
Summary
- Telotristat ethyl (Xermelo) is indicated for the treatment of carcinoid syndrome diarrhea in adults inadequately controlled by somatostatin analog (SSA) therapy.
- Four systematic reviews/meta-analyses were reviewed to gather information about telotristat ethyl's effectiveness and safety profile.
- One review found that telotristat ethyl reduced bowel movements in 40% of patients with diarrhea refractory to SSA, indicating its potential as an effective second-line treatment option for carcinoid syndrome symptoms.
- Another study suggested that the use of telotristat ethyl may be cost-effective if societal willingness to pay is high, highlighting its economic viability compared to other treatments available for this condition.
- A different review noted that interventions such as increased dose or frequency or interclass switch led to a reduction of flushes and/or diarrhea in 72-84% cases, suggesting possible strategies when initial response from drugs like Xermelo isn't satisfactory.
- The final study emphasized on the need for more prospective trials and standardized guidelines regarding symptom control measures including systemic treatments like Xermelo due to lack of consensus among studies related specifically towards treating carcinoid syndrome symptoms effectively while maintaining patient quality-of-life standards at optimal levels.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Xermelo (telotristat ethyl) Prescribing Information. | 2022 | Lexicon Pharmaceuticals, Inc., The Woodlands, TX |
Systematic Reviews / Meta-Analyses
| Document Title | Year | Source |
|---|---|---|
| Practical recommendations for the management of patients with gastroenteropancreatic and thoracic (carcinoid) neuroendocrine neoplasms in the COVID-19 era. | 2021 | European Journal of Cancer |
| A systematic review of economic and quality-of-life research in carcinoid syndrome. | 2021 | PharmacoEconomics |
| Clinical review report: telotristat (Xermelo). | 2019 | CADTH |
| Management of carcinoid syndrome: a systematic review and meta-analysis. | 2019 | Endocrine-Related Cancer |
| Systemic treatment options for carcinoid syndrome: a systematic review. | 2019 | Oncology |