Gabexate mesilate and/or octreotide in human immunodeficiency virus-associated pancreatic abnormalities.
BACKGROUND
Human immunodeficiency virus (HIV)-associated pancreatic alterations are frequent, but poorly investigated, notwithstanding their potential consequences on the course and management of HIV infection. No epidemiological or clinical data on pancreatic alterations have been published since the introduction of highly active antiretroviral therapy, and no indications of the pharmacological management of symptomatic or prolonged laboratory pancreatic abnormalities have been reported.


OBJECTIVE
To investigate the therapeutic role of gabexate mesilate and octreotide in HIV-infected patients with elevated, symptomatic or instrumentally confirmed pancreatic anomalies persisting for more than 3 months.


RESULTS
An open-label, prospective, 5-year case-control study was conducted involving 185 consecutive patients with pancreatic alterations. Treatment of patients with severe laboratory and/or clinical involvement with low-dose gabexate mesilate and/or somatostatin was effective and safe and led to a lower recurrence rate and a better tolerability of concomitant drug regimens compared with supportive therapy taken by control patients. Combined gabexate-octreotide proved to be more active than single drug administration.


CONCLUSIONS
Epidemiological and therapeutic data on the frequency, risk factors and clinical significance of pancreatic abnormalities during HIV infection are required, as are studies investigating the need for and choice of antisecretory and/or antiprotease compounds.
Manfredi
R
R
Department of Clinical and Experimental Medicine, Division of Infectious Diseases, University of Bologna, S. Orsola Hospital, Italy. manfredi@med.unibo.it
Calza
L
L
Chiodo
F
F
D000328:Adult; D016022:Case-Control Studies; D004338:Drug Combinations; D005260:Female; D016670:Gabexate / Q000627:therapeutic use*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D015282:Octreotide / Q000627:therapeutic use*; D010182:Pancreatic Diseases / Q000188:drug therapy* / Q000821:virology; D011446:Prospective Studies; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use*
D004338:Drug Combinations; D015842:Serine Proteinase Inhibitors; D016670:Gabexate; D015282:Octreotide