Palabras clave:Fallo intestinal. Teduglutida. Síndrome de intestino corto. GLP-2. Nutrición parenteral.
Key words:Intestinal failure. Teduglutide. Shortbowel syndrome. GLP-2. Parenteral nutrition.
AbstractIntroduction: Long-term Parenteral Support (PS) can be associated with serious complications, with a signifi cant deterioration in the quality of life of patients with short bowel syndrome (SBS). Teduglutide is a recombinant analogue of glucagon-like peptide-2; it belongs to a novel therapeutic family and represents the fi rst non-symptomatic approach against SBS. Objectives: To review the non-clinical and clinical data on effi cacy and safety of teduglutide. Results: Teduglutide approval was based on results from a pivotal Phase III, 24-week, double-blind, placebo-controlled study (STEPS). SBS patients dependent on PS ≥ 3 times/week for ≥ 12 months received 0.05 mg/kg teduglutide (n = 43) or placebo (n = 43) 1 time/day. At week 24 there were signifi cantly more responders in the teduglutide group vs. placebo (63 vs. 30%; p = 0.002). The overall mean reduction vs. PS baseline volume at week 24 was signifi cantly higher with teduglutide vs. placebo (4.4 vs. 2.3 l/ week, p < 0.001). At week 24 the need for PS was reduced in at least 1 day in 54% of patients treated with teduglutide vs. 23% with placebo. Of the total of patients who received teduglutide in phase III trials (n = 134), 12% achieved complete autonomy from PS. Subcutaneous teduglutide was generally well tolerated. Conclusions: Teduglutide has been shown to enhance intestinal absorptive capacity and signifi cantly reduce PS dependency, even achieving independency in some patients.