Treatment of adult short bowel syndrome patients with  teduglutide.
BACKGROUND
Parenteral support is lifesaving in short bowel syndrome patients with intestinal failure (SBS-IF), who are unable to compensate for their malabsorption by metabolic or pharmacologic adaptation. Mutually, the symptoms of SBS-IF and the inconveniences and complications in relation to parenteral support may cause impairment of the quality of life of SBS-IF patients. Conventional treatments include dietary manipulations, oral rehydration solutions, antidiarrheal and antisecretory treatments. However, the evidence base for these interventions is limited, and treatments improving structural and functional integrity of the remaining intestine are desired. Teduglutide , an analog of glucagon-like peptide 2, improves intestinal rehabilitation by promoting mucosal growth and possibly by inhibiting gastric emptying and secretion, which in turn reduces intestinal losses and promotes intestinal absorption.


METHODS
This paper reviews the following findings: in a 3-week, Phase II balance study, teduglutide reduced diarrhea by ∼ 700 g/day and fecal energy losses by ∼ 0.8 MJ/day, and in a randomized, placebo-controlled, 24-week, Phase III study, corresponding reductions in the need for parenteral support were obtained.


CONCLUSIONS
Teduglutide seems to be safe and well-tolerated and demonstrates restoration of structural and functional integrity of the remaining intestine with significant intestinotrophic and proabsorptive effects, facilitating a reduction in diarrhea and an equivalent reduction in the need for parenteral support in SBS-IF patients.
Department of Medicine CA-2121, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
Lærke Marijke
LM
Nørholk
Jens Juul
JJ
Holst
Palle Bekker
PB
Jeppesen
D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D053767:Glucagon-Like Peptide 2 / Q000627:therapeutic use*; D006801:Humans; D010455:Peptides / Q000627:therapeutic use*; D012778:Short Bowel Syndrome / Q000188:drug therapy*
D005765:Gastrointestinal Agents; D053767:Glucagon-Like Peptide 2; D010455:Peptides; C494910:teduglutide