Explosive, multiple episodes of diarrhoea are common in patients with neuroendocrine neoplasms affecting around 30% of the patient population. This is combination with other symptoms such as red, dry flushing and wheezing constitute carcinoid syndrome. This syndrome can have a devastating effect on patients impacting upon all aspects of their being. Somatostatin analogues alone can be successful in the management of diarrhoea however in some cases this is inadequate. In 2018 Telotristat was approved by the Scottish Medicines Consortium for patients who experience four or more bowel movements per day despite somatostatin analogues. A total of 13 patients from the West and East of Scotland have since been commenced on Telotristat, with 11 out of 13 demonstrating appreciable response to treatment. The greatest reduction in bowel motions was a patient who was having up to 15 bowel motions per day and following treatment with Telotristat this reduced to 2 motions per day. We have considered the physical and psychosocial symptoms experienced by patients with carcinoid syndrome diarrhoea and have demonstrated the positive impact on patients following treatment with Telotristat. Testimonials from 2 patients who were responsive to Telotristat have been included.
02 Dec 2019
UK and Ireland Neuroendocrine Tumour Society