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Can an amino acid-based oral rehydration solution be effective in managing immune therapy-induced diarrhea?
- Source :
-
Medical hypotheses [Med Hypotheses] 2019 Jun; Vol. 127, pp. 66-70. Date of Electronic Publication: 2019 Mar 27. - Publication Year :
- 2019
-
Abstract
- Immune checkpoint inhibitor (ICPi) therapy has transformed the way we treat cancer. However, its immune related adverse events (irAEs) can be debilitating and life threatening. Immune therapy-induced diarrhea (ITID) is one of the most commonly encountered irAEs and can lead to expensive and prolonged hospitalizations. The current standard of care for grade 3 or 4 ITID involves ICPi discontinuation, the initiation of steroids, and infliximab for refractory disease. This treatment regimen reverses the desired anti-tumor effect of ICPis, can lead to side effects, and is cost-ineffective. We report the first case of the successful treatment of grade 3 ITID with steroids and an amino acid-based oral rehydration solution (AA-ORS), enterade. Research suggests that AA-ORS may be used to reduce diarrhea and adequately hydrate patients, in contrast to glucose-based oral rehydration solutions, which have been implicated as a contributing factor to diarrhea in cancer patients. We hypothesize that an AA-ORS may mitigate ITID via safer and more economically viable means than the current standard of care, but more controlled trials are needed to test this hypothesis.<br /> (Copyright © 2019 Elsevier Ltd. All rights reserved.)
- Subjects :
- Administration, Oral
Amino Acids
Antineoplastic Agents therapeutic use
Bicarbonates administration & dosage
Clinical Trials as Topic
Colitis immunology
Colitis prevention & control
Female
Glucose administration & dosage
Humans
Immunotherapy
Middle Aged
Potassium Chloride administration & dosage
Practice Guidelines as Topic
Sodium Chloride administration & dosage
Steroids therapeutic use
Antineoplastic Agents adverse effects
Diarrhea chemically induced
Neoplasms drug therapy
Rehydration Solutions administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2777
- Volume :
- 127
- Database :
- MEDLINE
- Journal :
- Medical hypotheses
- Publication Type :
- Academic Journal
- Accession number :
- 31088651
- Full Text :
- https://doi.org/10.1016/j.mehy.2019.03.023