Background The aim of this study was to quantify the long‐term clinical outcomes for individuals receiving teduglutide for short‐bowel syndrome (SBS). Methods A single‐center, retrospective study was performed for individuals commencing use of teduglutide between March 2013 and May 2019. Results Eighteen patients were included in the final analysis, among which the median duration of teduglutide administration was 3.2 (range, 0.6–6.2) years. Twelve of 16 (75%) patients at 12 months, 10 of 13 (76.9%) at 24 months, 7 of 10 (70%) at 36 months, and 3 of 3 (100%) at 60 months had a response to teduglutide therapy, defined as a >20% reduction in parenteral support (PS) requirement. Among responders at 12, 24, and 36 months, the presence of a colon‐in‐continuity, an ileocecal valve, a response at 3 months, the length of small bowel, nor the baseline volume affected response to therapy (P > .05 for all comparisons). Five (28%) patients were able to achieve freedom from PS, among which all had a history of Crohn's disease with loss of the ileocecal valve and among which 3 had a colon‐in‐continuity. Four of the 5 patients discontinued PS by 6 months of teduglutide therapy. Conclusions In a real‐world experience, teduglutide therapy results in rapid and sustained reductions in PS. Larger postmarketing studies will be required to reliably predict response to treatment and the factors associated with enteral autonomy.

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Background: Current guidelines recommend that patients with chronic intestinal failure (CIF) should be managed by a multidisciplinary team (MDT). However, the characteristics of real-world IF centers and the patients they care for are lacking. The study aims to describe IF center characteristics as well as characteristics of patients with CIF across different global regions.Methods: This is an international multicenter study of adult IF centers using a survey. The questionnaire survey included questions regarding program and patient characteristics. Thirty-three investigational centers were invited to participate. Each center was asked to answer the survey questions as one MDT. Results: The survey center response rate was 91%. The median number of patients with CIF per center was 128 (range, 30-380). The most common disciplines reported were gastroenterologist (93%), dietitian (90%), nurse (83%), and advanced practitioner (nurse practitioner and physician assistant, 77%).

Background: International practice guidelines for high-stool-output (HSO) management in short bowel syndrome (SBS) are available, but data on implementation are lacking. This study describes the approach used to manage HSO in SBS patients across different global regions. Methods: This is an international multicenter study evaluating medical management of HSO in SBS patients using a questionnaire survey. Thirty-three intestinal-failure centers were invited to complete the survey as one multidisciplinary team. Results: Survey response rate was 91%. Dietary recommendations varied based on anatomy and geographic region. For patients without colon-in-continuity (CiC), clinical practices were generally consistent with ESPEN guidelines, including separation of fluid from solid food (90%), a high-sodium diet (90%), and a low-simple-sugar diet (75%). For CiC patients, practices less closely followed guidelines, such as a low-fat diet (35%) or a high-sodium diet (50%). First-line antimotility and antisecretory medications were loperamide and proton-pump inhibitors. Other therapeutic agents (e.g., pancreatic enzymes and bile acid binders) were utilized in real-world practices, and usage varied based on intestinal anatomy. Conclusion: Expert centers largely followed published HSO-management guidelines for SBS patients without CiC, but clinical practices deviated substantially for CiC patients. Determining the reasons for this discrepancy might inform future development of practice guidelines.

INTRODUCTION: Intestinal failure (IF) results from a variety of causes leading to need for parenteral support (PS). Teduglutide was approved for adult patients requiring PS in December 2012. Teduglutide is a glucagon-like peptide 2 (GLP-2) analogue that aids in the growth of the intestinal villi and reduces gastric emptying, thereby promoting absorption of fluids, calories and electrolytes. Previous studies have shown that teduglutide has decreased PS use by >20% at 12 and 24 months. Long term efficacy data has not been studied. Our aim is to present 3 and 5 year patient outcomes on teduglutide. METHODS: Data was collected retrospectively from a single center including patients requiring PS that also received teduglutide between 3/1/13 and 5/1/19. Patient demographics including length of small intestine, presence/absence of an ileocecal valve and duration of PS was recorded. Outcomes of teduglutide therapy were recorded at 12, 24, 36, and 60 months with respect to PS volume, calories, days per week of PS use, and ability to stop PS. Response to teduglutide was defined as a > 20% reduction in PS compared to baseline volume. Data were analyzed using Fischer’s exact test for categorical variables and one-way ANOVA for comparison of means followed by Dunnett’s test. RESULTS: Patient demographic and IF etiology data is presented in Table 1. Eighteen patients were included in the final analysis. Indications for stopping teduglutide are listed in Table 2. Baseline and longitudinal PS requirements, weight trends and responders are shown in Table 3. Among individuals with follow-up, the number of responders was 11/16 (69%) at 12 months, 10/13 (77%) at 24 months, 7/10 (70%) at 36 months and 3/3 (100%) at 60 months. Among responders, the presence of a colon in continuity, ileocecal valve, or length of remaining small bowel did not affect TPN requirement (P > 0.05 for all comparisons). Ten out of 16 (63%) patients had a one or more day decrease in TPN frequency at 12 months, 9/13 (69%) at 24 months, 6/10 (60%) at 36 months, and 3/3 (100%) at 60 months. Change in PS volume and days of PS per week were significantly lower at 24 months and 60 months (Table 3). CONCLUSION: Previous studies have shown that teduglutide therapy decreases PS requirements in patients requiring PS over 12 and 24 months. We found that patients achieving reductions in PS requirements can successfully continue teduglutide therapy for up to 5 years with continued reductions in PS volume and days.