Evidence map›Paper›PMID 30651397›Full record

ArticleThe oncologist2019

Long-Term Safety Experience with Telotristat Ethyl Across Five Clinical Studies in Patients with Carcinoid Syndrome.

Lowell B Anthony, Matthew H Kulke, Martyn E Caplin, Emily Bergsland, Kjell Öberg, Marianne Pavel, Dieter Hörsch, Richard R P Warner, Thomas M O'Dorisio, Joseph S Dillon and 3 more

Open access · bronzeAbstract read
In one paragraph

Article in The oncologist, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Update in carcinoid heart disease - the heart of the matter.Reviews in endocrine & metabolic disorders · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 10 institutions in 4 countries.

Lowell B AnthonyMarkey Cancer Center, University of Kentucky, Lexington, Kentucky, USA.
Matthew H KulkeBoston University Medical Center, Boston, Massachusetts, USA.
Martyn E CaplinNeuroendocrine Tumor Unit, ENETS Centre of Excellence, Royal Free Hospital, London, United Kingdom.
Emily BergslandDepartment of Medicine, University of California, San Francisco, San Francisco, California, USA.
Kjell ÖbergDepartment of Endocrine Oncology, Uppsala University, Uppsala, Sweden.
Marianne PavelDepartment of Hepatology and Gastroenterology, Charité - Universitätsmedizin, Berlin, Germany.
Dieter HörschDepartment of Gastroenterology/Endocrinology, Center for Neuroendocrine Tumors, Zentralklinik Bad Berka, Bad Berka, Germany.
Richard R P WarnerDivision of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York New York, USA.
Thomas M O'DorisioDepartment of Internal Medicine - Endocrinology and Metabolism, University of Iowa, Iowa City, Iowa, USA.
Joseph S DillonDepartment of Internal Medicine - Endocrinology and Metabolism, University of Iowa, Iowa City, Iowa, USA.
Pablo LapuertaLexicon Pharmaceuticals, Inc., The Woodlands, Texas, USA.
Kenneth Kassler-TaubLexicon Pharmaceuticals, Inc., The Woodlands, Texas, USA.
Wenjun JiangLexicon Pharmaceuticals, Inc., The Woodlands, Texas, USA wjiang@lexpharma.com.
Lexicon Pharmaceuticals (United States) · USUniversity of Iowa · USBoston Medical Center · USCharité - Universitätsmedizin Berlin · DEIcahn School of Medicine at Mount Sinai · USUniversity College London · GBUniversity of California, San Francisco · USUniversity of Kentucky · USUppsala University · SEZentralklinik Bad Berka · DE

Funding

Viral VectorP30CA086862 · NCI · UNIVERSITY OF IOWA · PI Christopher K Laubenthal · 2000 to 2026
$70.0M
Project 4: New Approaches to Improving the Effectiveness of Radionuclide Targeted Treatments in Neuroendocrine TumorsP50CA174521 · NCI · UNIVERSITY OF IOWA · PI ODORISIO, THOMAS · 2015 to 2021
$13.2M
NCI NIH HHS P50 CA174521
6 · The paper itself

Abstract

backgroundPatients with neuroendocrine tumors (NETs) and carcinoid syndrome experience considerable morbidity and mortality; carcinoid syndrome may be associated with shorter survival. Carcinoid syndrome is linked to tumoral secretion of serotonin and other bioactive substances. The subsequent debilitating diarrhea and urgency to defecate pose significant health risks. In previous studies, telotristat ethyl, a tryptophan hydroxylase inhibitor, was effective and well tolerated in treating carcinoid syndrome diarrhea. We present pooled safety data from five clinical trials with telotristat ethyl in patients with carcinoid syndrome. SUBJECTS, MATERIALS, AND

methodsAdverse events reported during telotristat ethyl treatment were pooled from two phase II and three phase III clinical trials in 239 patients with carcinoid syndrome. Long-term safety of telotristat ethyl and causes of hospitalization and death were reviewed; overall survival was estimated.

resultsMean (median; range) duration of exposure and follow-up was 1.3 years (1.1 years; 1 week to 5.7 years), with 309 total patient-years of exposure. Leading causes of hospitalization were gastrointestinal disorders or were related to the underlying tumor and related treatment. Survival estimates at 1, 2, and 3 years were 93%, 88%, and 77%. Nearly all deaths were due to progression or complication of the underlying disease; none were attributable to telotristat ethyl. There was one death in year 4.

conclusionBased on long-term safety data, telotristat ethyl is well tolerated and has a favorable long-term safety profile in patients with carcinoid syndrome. IMPLICATIONS FOR PRACTICE: Carcinoid syndrome can cause persistent diarrhea, even in patients treated with somatostatin analogs. Across five clinical trials in patients with carcinoid syndrome, telotristat ethyl has been well tolerated and efficacious, providing clinicians with a new approach to help control carcinoid syndrome diarrhea, in addition to somatostatin analog therapy. By reducing the stool frequency in patients with carcinoid syndrome whose diarrhea is refractory to anticholinergics, such as loperamide and atropine/diphenoxylate, and somatostatin analog dose escalation, improvement in quality of life becomes an achievable goal.

Indexed as

AdultAgedAged, 80 and overAntineoplastic AgentsClinical Trials, Phase II as TopicClinical Trials, Phase III as TopicDiarrheaFemaleHumansMaleMalignant Carcinoid SyndromeMiddle AgedPatient SafetyPhenylalaninePyrimidinesRandomized Controlled Trials as TopicAntineoplastic AgentsPhenylalaninePyrimidinestelotristat ethylDiarrheaMalignant carcinoid syndromeNeuroendocrine tumorsSerotoninTelotristat ethylTryptophan hydroxylase

Identifiers

PMID30651397
PMCPMC6693702
OpenAlexW2910717974

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.