Effect of liraglutide treatment on jejunostomy output in patients with short bowel syndrome: An open-label pilot study

Mark Hvistendahl; Christopher Filtenborg Brandt; Siri Tribler; Rahim Mohammad Naimi; Bolette Hartmann; Jens Juul Holst; Jens Frederik Rehfeld; Mads Hornum; Jens Rikardt Andersen; Birthe Merete Henriksen; Per Brøbech Mortensen; Palle Bekker Jeppesen

doi:10.1177/0148607116672265

Effect of liraglutide treatment on jejunostomy output in patients with short bowel syndrome: An open-label pilot study

Mark Hvistendahl, Christopher Filtenborg Brandt, Siri Tribler, Rahim Mohammad Naimi, Bolette Hartmann, Jens Juul Holst, Jens Frederik Rehfeld, Mads Hornum, Jens Rikardt Andersen, Birthe Merete Henriksen, Per Brøbech Mortensen, Palle Bekker Jeppesen

25 Citationer (Scopus)

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.

MATERIALS AND 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).

CONCLUSION: 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.

Originalsprog	Engelsk
Tidsskrift	Journal of Parenteral and Enteral Nutrition
Vol/bind	42
Udgave nummer	1
Sider (fra-til)	112-121
Antal sider	10
ISSN	0148-6071
DOI	https://doi.org/10.1177/0148607116672265
Status	Udgivet - jan. 2018

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10.1177/0148607116672265

Citationsformater

Hvistendahl, M., Brandt, C. F., Tribler, S., Naimi, R. M., Hartmann, B., Holst, J. J., Rehfeld, J. F., Hornum, M., Andersen, J. R., Henriksen, B. M., Brøbech Mortensen, P., & Jeppesen, P. B. (2018). Effect of liraglutide treatment on jejunostomy output in patients with short bowel syndrome: An open-label pilot study. Journal of Parenteral and Enteral Nutrition, 42(1), 112-121. https://doi.org/10.1177/0148607116672265

Hvistendahl, M, Brandt, CF, Tribler, S, Naimi, RM, Hartmann, B , Holst, JJ , Rehfeld, JF , Hornum, M , Andersen, JR, Henriksen, BM, Brøbech Mortensen, P & Jeppesen, PB 2018, 'Effect of liraglutide treatment on jejunostomy output in patients with short bowel syndrome: An open-label pilot study', Journal of Parenteral and Enteral Nutrition, bind 42, nr. 1, s. 112-121. https://doi.org/10.1177/0148607116672265

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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.MATERIALS AND 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).CONCLUSION: 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.",

keywords = "Faculty of Science, Short bowel syndrome, Gastroenterology, Parenteral nutrition, Nutrition, Diarrhea, Research, Disease",

author = "Mark Hvistendahl and Brandt, {Christopher Filtenborg} and Siri Tribler and Naimi, {Rahim Mohammad} and Bolette Hartmann and Holst, {Jens Juul} and Rehfeld, {Jens Frederik} and Mads Hornum and Andersen, {Jens Rikardt} and Henriksen, {Birthe Merete} and {Br{\o}bech Mortensen}, Per and Jeppesen, {Palle Bekker}",

note = "CURIS 2018 NEXS 032 Obs! Forlaget linker stadig til artiklen i [Epub]... (22/1/2018)",

year = "2018",

month = jan,

doi = "10.1177/0148607116672265",

language = "English",

volume = "42",

pages = "112--121",

journal = "Journal of Parenteral and Enteral Nutrition",

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TY - JOUR

T1 - Effect of liraglutide treatment on jejunostomy output in patients with short bowel syndrome

T2 - An open-label pilot study

AU - Hvistendahl, Mark

AU - Brandt, Christopher Filtenborg

AU - Tribler, Siri

AU - Naimi, Rahim Mohammad

AU - Hartmann, Bolette

AU - Holst, Jens Juul

AU - Rehfeld, Jens Frederik

AU - Hornum, Mads

AU - Andersen, Jens Rikardt

AU - Henriksen, Birthe Merete

AU - Brøbech Mortensen, Per

AU - Jeppesen, Palle Bekker

N1 - CURIS 2018 NEXS 032 Obs! Forlaget linker stadig til artiklen i [Epub]... (22/1/2018)

PY - 2018/1

Y1 - 2018/1

N2 - 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.MATERIALS AND 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).CONCLUSION: 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.

AB - 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.MATERIALS AND 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).CONCLUSION: 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.

KW - Faculty of Science

KW - Short bowel syndrome

KW - Gastroenterology

KW - Parenteral nutrition

KW - Nutrition

KW - Diarrhea

KW - Research

KW - Disease

U2 - 10.1177/0148607116672265

DO - 10.1177/0148607116672265

M3 - Journal article

C2 - 27875281

SN - 0148-6071

VL - 42

SP - 112

EP - 121

JO - Journal of Parenteral and Enteral Nutrition

JF - Journal of Parenteral and Enteral Nutrition

IS - 1

ER -

Effect of liraglutide treatment on jejunostomy output in patients with short bowel syndrome: An open-label pilot study

Abstract

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