title: Crofelemer, a novel antisecretory agent approved for the treatment of HIV-associated diarrhea.
abstract: Secretory diarrhea has a significant impact on morbidity and mortality worldwide and may be a predominant or minor component of pathogenesis in diarrhea of various etiologies. Crofelemer is a first-in-class antidiarrheal medication with unique inhibitory mechanisms at both the cystic fibrosis transmembrane conductance regulator and the calcium-activated chloride channels which are responsible for chloride secretion and subsequent luminal hydration. The efficacy of crofelemer has been investigated in patients with HIV-associated diarrhea, diarrhea of various infectious etiologies, as well as diarrhea-predominant irritable bowel syndrome. Crofelemer was approved by the FDA in December 2012 to treat diarrhea in HIV/AIDS patients on antiretroviral therapy. Crofelemer is not absorbed in the body and well-tolerated in small trials performed to date although long-term safety data is lacking. Crofelemer may be an important addition to the currently available drugs for the management of secretory diarrhea.
authors.affiliation: National University of Singapore, Singapore. kgarey@uh.edu
authors.forename: Q M
authors.initials: QM
authors.lastname: Yeo
authors.forename: R
authors.initials: R
authors.lastname: Crutchley
authors.forename: J
authors.initials: J
authors.lastname: Cottreau
authors.forename: A
authors.initials: A
authors.lastname: Tucker
authors.forename: K W
authors.initials: KW
authors.lastname: Garey
mesh_terms: D000818:Animals; D000930:Antidiarrheals / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D003967:Diarrhea / Q000188:drug therapy* / Q000821:virology; D004347:Drug Interactions; D015658:HIV Infections / Q000150:complications; D006801:Humans; D044945:Proanthocyanidins / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000930:Antidiarrheals; D044945:Proanthocyanidins; C546704:crofelemer
keywords: CFTR gene; Cholera; Clostridium difficile; Crofelemer; Diarrhea; HIV/AIDS