EMERGING INDICATIONS FOR OCTREOTIDE THERAPY .1.

Possible new indications for the use of octreotide are discussed. In O ctober 1988, octreotide received FDA-approved labeling for use in the management of carcinoid syndrome and vipomas. Since that time, researc h results and clinical experience have accumulated that suggest a pote ntially much broader therapeutic role for octreotide. Reports continue to be published on the use of octreotide for treating pituitary tumor s, gastroenteropancreatic tumors, diabetes mellitus, AIDS-associated d iarrhea, autonomic neuropathy, pancreatitis, pancreatic pseudocysts an d ascites, complications of pancreatic surgery and transplantation, il eostomy-associated diarrhea, enterocutaneous fistulas, pancreatic fist ulas, dumping syndrome, short bowel syndrome, and gastrointestinal ble eding. Other emerging indications for the use of octreotide include ps oriasis, hypercalcemia, cancer-related pain, polycystic ovary syndrome , and certain cancers. In children, octreotide has been studied for us e in treating hyperinsulinemic hypoglycemia of infancy. Along with the common adverse effects of octreotide, such as pain at the injection s ite and nausea, less frequent effects, such as cholelithiasis, gallbla dder hypercontractility, and gastritis have now been described. Much o f what has been learned is based on small uncontrolled studies and cas e reports, since the rarity of many of the conditions for which octreo tide has shown promise has tended to preclude larger studies. As clini cal experience with octreotide accumulates and better-designed trials are completed where possible, a broader therapeutic role for octreotid e is likely to be recognized.