title: Maintenance of parenteral nutrition volume reduction, without weight loss, after stopping teduglutide in a subset of patients with short bowel syndrome.
abstract: BACKGROUND
  Teduglutide was discontinued after being tested for ≥ 24 weeks in patients with parenteral nutrition (PN) -dependent short bowel syndrome in a clinical trial for efficacy to reduce PN volume. This study was describes change in body mass index (BMI) and PN volume over 12 months in patients who stopped drug after the clinical trial.
  
  
  METHODS
  Prescribed PN volume, weight, and complications were reported. Patients with stable (NEUT, n = 15) or decreased (DEC, n = 7) PN volume by 12 months after stopping drug (NEUT/DEC, n = 22) were compared to those who had increased PN volume (INC, n = 15). With drug response defined by ≥ 20% reduction from pre-drug PN volume to end of drug therapy, 12 INC and 13 NEUT/DEC patients were drug responders.
  
  
  RESULTS
  Eleven of 20 eligible sites reported data for 39 of 53 eligible study participants, with follow-up data for 37. INC patients had shorter colon and less frequently had colon in continuity than NEUT/DEC. BMI was decreased at 3, 6, and 12 months relative to the first off-drug visit in INC patients (P = .001), but not in NEUT/DEC patients. Change in BMI off-drug was predicted by colon and small bowel length, baseline BMI, and on-drug change in PN volume (adjusted R2 = 0.708).
  
  
  CONCLUSIONS
  Gastrointestinal anatomy, baseline BMI, and PN volume reduction on-drug predicted change in BMI off-drug. Whether this response would be maintained for a longer time or in the context of a challenging clinical situation has not been evaluated.
authors.affiliation: Department of Nutrition, University of Pennsylvania School of Nursing, Philadelphia, PA 19104-4217, USA. compherc@nursing.upenn.edu
authors.forename: Charlene
authors.initials: C
authors.lastname: Compher
authors.forename: Richard
authors.initials: R
authors.lastname: Gilroy
authors.forename: Marek
authors.initials: M
authors.lastname: Pertkiewicz
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Ziegler
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Ratcliffe
authors.forename: Francisca
authors.initials: F
authors.lastname: Joly
authors.forename: Fedja
authors.initials: F
authors.lastname: Rochling
authors.forename: Bernard
authors.initials: B
authors.lastname: Messing
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007421:Intestine, Small / Q000187:drug effects; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000379:methods*; D010455:Peptides / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D012778:Short Bowel Syndrome / Q000628:therapy*; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
chemical_list: D010455:Peptides; C494910:teduglutide