Long‐Term Outcomes With Teduglutide From a Single Center

Abstract

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.

Efficacy of Teduglutide for Parenteral Support Reduction in Patients with Short Bowel Syndrome: A Systematic Review and Meta-Analysis

“…An accurate title or abstract revision was sufficient to exclude 401 articles as not pertinent or not fulfilling our prespecified inclusion or exclusion criteria. The remaining 34 studies were assessed in full-text for eligibility; 10 of them finally met all criteria for being included in the final analysis [27,28,[43][44][45][46][47][48][49][50]; 2 additional post hoc analyses were employed for data extraction [35,37], as they contained additional and relevant information for the assessment of the outcomes of 3 among the 10 pertinent papers [28,45,49]. The process of study selection is summarized in Figure 1.…”

“…Table 1 summarizes the basic study characteristics. Two studies had a randomized, placebo-controlled, double-blinded design [27,28]; the remaining eight studies were characterized by an observational design [43][44][45][46][47][48][49][50]. Among these, one was actually designed as a randomized controlled trial (RCT) [45], but the randomization and the blindness of treatment assignment was performed between different teduglutide dosing schedules rather than between the teduglutide and placebo; therefore, to the scope of our analyses, this study falls in the group of "observational" ones, since both the investigators and the patients were aware that a treatment with the drug was actually in place.…”

Teduglutide in short bowel syndrome patients: A way back to normal life?

“…Jeppesen et al were able to show in a phase III placebo‐controlled trial that 63% of patients receiving teduglutide were able to reduce PS volume by ≥20% after 24 weeks 13 . Since then, several studies have demonstrated the efficacy of teduglutide 14–19 . Nevertheless, a significant discrepancy in success rates can be noted when comparing enteral autonomy rates ranging from 12% to 28% 14–16,20 …”

Short‐Bowel Syndrome: Epidemiology, Hospitalization Trends, In‐Hospital Mortality, and Healthcare Utilization

“…23,62 However, because of medical advancements, PN is no longer considered the final option for management of these patients, and newer medications, which include enterohormonal therapy with glucagon-like peptide analogs such as teduglutide, have shown promising results and are now available for management of SBS. [63][64][65][66] Bowel-lengthening procedures, including serial transverse enteroplasty procedure and intestinal transplants, are also increasingly being utilized. 57 There has been a substantial increase in the knowledge of complications associated with IF and PN use.…”

“…Home PN care is easily accessible in the majority of developed countries, including the US, and patients can self‐care and infuse the PN at home 23,62 . However, because of medical advancements, PN is no longer considered the final option for management of these patients, and newer medications, which include enterohormonal therapy with glucagon‐like peptide analogs such as teduglutide, have shown promising results and are now available for management of SBS 63–66 . Bowel‐lengthening procedures, including serial transverse enteroplasty procedure and intestinal transplants, are also increasingly being utilized 57 .…”