A new evidence-based treatment protocol for persistent diarrhea associated with carcinoid syndrome     Telotristat: A new option for consideration for patients with persistent diarrhea from poorly controlled carcinoid syndrome (in combination with SSA)1 XERMELO is a tryptophan hydroxylase inhibitor indicated for the treatment of carcinoid syndrome diarrhea in combination with somatostatin analog (SSA) therapy in adults inadequately controlled by SSA therapy.2       Dear {{accFname}} {{accLname}}, I am excited to announce that telotristat ethyl (XERMELO) is now included as an option in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Neuroendocrine Tumors.1 Telotristat ethyl is included as a category 2A, second-line option in combination with octreotide or lanreotide for patients experiencing persistent diarrhea following treatment with octreotide or lanreotide.1     Click here to view the latest NCCN Guidelines® for Neuroendocrine Tumors     This recommendation is based on results from the TELESTAR study, a multicenter, randomized, double-blind, placebo-controlled, Phase III trial of XERMELO + SSA (n=45) vs SSA alone (n=45).1,2         IN THIS STUDY         • XERMELO + SSA delivered comprehensive control of tumor-derived serotonin, as measured by urinary 5‑HIAA3-5 • XERMELO provided a superior, 2x greater reduction in daily bowel-movement frequency averaged over 12 weeks (–1.4 with XERMELO 250 mg + SSA vs –0.6 with SSA alone; P<0.001) 2 • Only patients receiving XERMELO reported being "very satisfied" with their treatment: 50% vs 0% with SSA alone6 – Among the 33 patients who were interviewed for satisfaction level, 12 of 24 patients receiving XERMELO + SSA reported being very satisfied vs 0 of 9 receiving SSA alone • The most common adverse reactions (≥5%) include nausea, headache, increased gamma-glutamyl-transferase, depression, flatulence, decreased appetite, peripheral edema, and pyrexia2     5-HIAA=5-hydroxyindoleacetic acid.       For more information about XERMELO, visit XERMELO.com or click here for the full Prescribing Information.       Important Safety Information   • Warnings and Precautions: XERMELO may cause constipation, which can be serious. Monitor for signs and symptoms of constipation and/or severe, persistent, or worsening abdominal pain in patients taking XERMELO. Discontinue XERMELO if severe constipation or severe, persistent, or worsening abdominal pain develops.   • Drug Interactions: If necessary, consider increasing the dose of concomitant CYP3A4 substrates, as XERMELO may decrease their systemic exposure. If combination treatment with XERMELO and short-acting octreotide is needed, administer short-acting octreotide at least 30 minutes after administering XERMELO.   For more information about XERMELO, please see full Prescribing Information.   Get access to XERMELO with LexCares     LexCares is a comprehensive program designed by Lexicon to provide information and tools needed to simplify access to XERMELO and improve patients' chances for a successful clinical outcome. Visit LexCares to complete the Enrollment Form.   I look forward to meeting with you and your staff to discuss how XERMELO may be an appropriate option for your patients with carcinoid syndrome. If you have any questions, please feel free to contact me by replying to this email.   Sincerely, {{userName}} Lexicon Pharmaceuticals, Inc.   The National Comprehensive Cancer Network makes no warranties of any kind whatsoever regarding the content, use, or application of its guidelines and disclaims any responsibility for their application or use in any way.   References: 1. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Neuroendocrine Tumors 3.2017. © National Comprehensive Cancer Network, Inc. 2017. All rights reserved. Accessed June 14, 2017. To view the most recent and complete version of the guidelines, go online to NC‍CN.o‍rg. 2. XERMELO Prescribing Information. The Woodlands, TX: Lexicon Pharmaceuticals, Inc.; February 2017. 3. Rubin J, Ajani J, Schirmer W, et al. J Clin Oncol. 1999;17:600-606. 4. Kulke MH, Shah MH, Benson AB 3rd, et al. J Natl Compr Canc Netw. 2015;13:78-108. 5. Data on file. Lexicon Pharmaceuticals, Inc. 2017. 6. Anthony L, Hörsch D, Ervin C, et al. Assessing treatment benefit of telotristat etiprate in patients with carcinoid syndrome: patient exit interviews. Paper presented at: 2015 Neuroendocrine Tumor Symposium; October 15-17, 2015; Austin, TX.       This email is intended for US healthcare professionals only. To unsubscribe from Lexicon Pharmaceuticals, Inc. communications, click here. Lexicon Pharmaceuticals, Inc. 88‍00 Technology Forest Pl‍ace The Woodlands, T‍X 77‍381-11‍60 Copyright © 2017 Lexicon Pharmaceuticals, Inc. All rights reserved. PP-LX1606-US-0231 0‍8/1‍7