F Joly1, D Seguy2, A Nuzzo3, C Chambrier4, P Beau5, F Poullenot6, R Thibault7, L Armengol Debeir8, S Layec9, V Boehm3, J Lallemand10, D Quilliot11, S M Schneider12. 1. Gastroenterology, IBD and Nutritional Support Department, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, F-92110 Clichy, France; Gastrointestinal and Metabolic Dysfunctions in Nutritional Pathologies, Inserm UMRS 1149, Université Paris Diderot Paris 7, France. Electronic address: francisca.joly@aphp.fr. 2. Nutrition Unit, CHU Lille, INSERM U995 - LIRIC - Lille Inflammation Research International Center, F-59000 Lille, France. 3. Gastroenterology, IBD and Nutritional Support Department, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, F-92110 Clichy, France. 4. Hospices Civils de Lyon, Service de Nutrition Clinique Intensive, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69465 Pierre Benite, France. 5. Service d'Hépato-Gastro-Entérologie et Assistance Nutritive, Centre Agréé de Nutrition Parentérale à Domicile, 86021 Poitiers Cédex, France. 6. CHU de Bordeaux, Hôpital Haut-Lévêque, Service d'Hépato-gastroentérologie, CMC Magellan, F-33000 Bordeaux, Pessac, France. 7. INRA, INSERM, Univ Rennes, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France. 8. CHU de Rouen, Service de Gastroentérologie, 76031 Rouen, France. 9. Digestive and Nutritional Rehabilitation Unit, Clinique Saint-Yves, Rennes, France. 10. Hôpital Privé Marseille Vert Coteau, Unité de Réanimation et Surveillance Continue, 13012 Marseille, France. 11. Unité d'Assistance Nutritionnelle et de l'Unité Transversale de Nutrition - CHU Nancy, Nancy, France. 12. Gastroentérologie et Nutrition, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France.
Abstract
BACKGROUND & AIMS: Teduglutide, a GLP-2-analog, has proven effective in two placebo-controlled studies in reducing parenteral support (PS) in patients with short bowel syndrome-associated intestinal failure (SBS-IF) after 24 weeks. The aim of this study was to describe in a real-life situation the effects of teduglutide treatment and their predictive factors. METHODS: We included 54 consecutive SBS-IF patients treated with teduglutide in France for at least 6 months from 10 expert centers. Small bowel length was 62 ± 6 cm and 65% had colon in continuity. PS was 4.4 ±0 .2 infusions per week, started 9.8 ± 1.2 years before. Response (PS reduction ≥ 20%) and PS discontinuation rates were assessed at week 24. Adjusted p values of factors associated with response and weaning were calculated using a multivariate logistic regression model. RESULTS: At week 24, 85% of patients were responders and 24% had been weaned off PS, with a 51% reduction of PS needs and 1.5 ± 0.2 days off PS per week. Response to teduglutide was influenced by a higher baseline oral intake (p = 0.02). Weaning off PS was influenced by the presence of colon (p = 0.04), a lower PS volume (p = 0.03) and a higher oral intake (p = 0.01). There were no differences based on age, bowel length or SBS-IF causes. CONCLUSIONS: Our study confirms the effectiveness of teduglutide in reducing PS needs in SBS-IF patients. We associated reduced parenteral support volume with baseline parenteral volume support, bowel anatomy, and oral intake. These findings underline the role of nutritional optimization when starting the treatment.
BACKGROUND & AIMS:Teduglutide, a GLP-2-analog, has proven effective in two placebo-controlled studies in reducing parenteral support (PS) in patients with short bowel syndrome-associated intestinal failure (SBS-IF) after 24 weeks. The aim of this study was to describe in a real-life situation the effects of teduglutide treatment and their predictive factors. METHODS: We included 54 consecutive SBS-IFpatients treated with teduglutide in France for at least 6 months from 10 expert centers. Small bowel length was 62 ± 6 cm and 65% had colon in continuity. PS was 4.4 ±0 .2 infusions per week, started 9.8 ± 1.2 years before. Response (PS reduction ≥ 20%) and PS discontinuation rates were assessed at week 24. Adjusted p values of factors associated with response and weaning were calculated using a multivariate logistic regression model. RESULTS: At week 24, 85% of patients were responders and 24% had been weaned off PS, with a 51% reduction of PS needs and 1.5 ± 0.2 days off PS per week. Response to teduglutide was influenced by a higher baseline oral intake (p = 0.02). Weaning off PS was influenced by the presence of colon (p = 0.04), a lower PS volume (p = 0.03) and a higher oral intake (p = 0.01). There were no differences based on age, bowel length or SBS-IF causes. CONCLUSIONS: Our study confirms the effectiveness of teduglutide in reducing PS needs in SBS-IFpatients. We associated reduced parenteral support volume with baseline parenteral volume support, bowel anatomy, and oral intake. These findings underline the role of nutritional optimization when starting the treatment.