title: Effect of Liraglutide Treatment on Jejunostomy Output in Patients With Short Bowel Syndrome: An Open-Label Pilot Study.
abstract: BACKGROUND
  An impaired hormonal "ileo-colonic brake" may contribute to rapid gastric emptying, gastric hypersecretion, high ostomy losses, and the need for parenteral support in end-jejunostomy short bowel syndrome (SBS) patients with intestinal failure (IF). Liraglutide, a glucagon-like peptide 1 receptor agonist, may reduce gastric hypersecretion and dampen gastric emptying, thereby improving conditions for intestinal absorption.
  
  
  METHODS
  In an 8-week, open-label pilot study, liraglutide was given subcutaneously once daily to 8 end-jejunostomy patients, aged 63.4 ± 10.9 years (mean ± SD) and with small bowel lengths of 110 ± 66 cm. The 72-hour metabolic balance studies were performed before and at the end of treatment. Food intake was unrestricted. Oral fluid intake and parenteral support volume were kept constant. The primary end point was change in the ostomy wet weight output.
  
  
  RESULTS
  Liraglutide reduced ostomy wet weight output by 474 ± 563 g/d from 3249 ± 1352 to 2775 ± 1187 g/d (P = .049, Student t test). Intestinal wet weight absorption tended to increase by 464 ± 557 g/d (P = .05), as did urine production by 765 ± 759 g/d (P = .02). Intestinal energy absorption improved by 902 ± 882 kJ/d (P = .02).
  
  
  CONCLUSIONS
  Liraglutide reduced ostomy wet weight output in end-jejunostomy patients with SBS-IF and increased their intestinal wet weight and energy absorption. If larger, randomized, placebo-controlled studies confirm these effects, it adds to the hypothesis that many ileo-colonic brake hormones in conjunction may be involved in the process of intestinal adaptation. By identification of key hormones and addressing their potential synergistic effects, better treatments may be provided to patients with SBS-IF. This trial was registered at clinicaltrialsregister.eu as 2013-005499-16.
authors.affiliation: Department of Medical Gastroenterology CA-2121, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Mark
authors.initials: M
authors.lastname: Hvistendahl
authors.affiliation: Department of Medical Gastroenterology CA-2121, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Christopher Filtenborg
authors.initials: CF
authors.lastname: Brandt
authors.affiliation: Department of Medical Gastroenterology CA-2121, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Siri
authors.initials: S
authors.lastname: Tribler
authors.affiliation: Department of Medical Gastroenterology CA-2121, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Rahim Mohammad
authors.initials: RM
authors.lastname: Naimi
authors.affiliation: Department of Biomedical Sciences, NNF Center of Basic Metabolic Research, Copenhagen, Denmark.
authors.forename: Bolette
authors.initials: B
authors.lastname: Hartmann
authors.affiliation: Department of Biomedical Sciences, NNF Center of Basic Metabolic Research, Copenhagen, Denmark.
authors.forename: Jens Juul
authors.initials: JJ
authors.lastname: Holst
authors.affiliation: Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Jens Frederik
authors.initials: JF
authors.lastname: Rehfeld
authors.affiliation: Department of Nephrology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Mads
authors.initials: M
authors.lastname: Hornum
authors.affiliation: Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jens Rikardt
authors.initials: JR
authors.lastname: Andersen
authors.affiliation: Department of Diagnostic Radiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Birthe Merete
authors.initials: BM
authors.lastname: Henriksen
authors.affiliation: Department of Medical Gastroenterology CA-2121, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Brøbech Mortensen
authors.affiliation: Department of Medical Gastroenterology CA-2121, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Palle Bekker
authors.initials: PB
authors.lastname: Jeppesen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007582:Jejunostomy / Q000379:methods*; D000069450:Liraglutide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000706:statistics & numerical data; D010865:Pilot Projects; D012778:Short Bowel Syndrome / Q000188:drug therapy* / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D000069450:Liraglutide
keywords: diarrhea; gastroenterology; nutrition; parenteral nutrition; research and diseases; short bowel syndrome