Treatment of adult short bowel syndrome patients with teduglutide

TY - JOUR

T1 - Treatment of adult short bowel syndrome patients with teduglutide

AU - Nørholk, Lærke Marijke

AU - Holst, Jens Juul

AU - Jeppesen, Palle Bekker

PY - 2012/2

Y1 - 2012/2

N2 - INTRODUCTION: Parenteral support is lifesaving in short bowel syndrome patients with intestinal failure (SBS-IF), who are unable to compensate for their malabsorption by metabolic or pharmacologic adaptation. Mutually, the symptoms of SBS-IF and the inconveniences and complications in relation to parenteral support may cause impairment of the quality of life of SBS-IF patients. Conventional treatments include dietary manipulations, oral rehydration solutions, antidiarrheal and antisecretory treatments. However, the evidence base for these interventions is limited, and treatments improving structural and functional integrity of the remaining intestine are desired. Teduglutide , an analog of glucagon-like peptide 2, improves intestinal rehabilitation by promoting mucosal growth and possibly by inhibiting gastric emptying and secretion, which in turn reduces intestinal losses and promotes intestinal absorption. AREAS COVERED: This paper reviews the following findings: in a 3-week, Phase II balance study, teduglutide reduced diarrhea by ~ 700 g/day and fecal energy losses by ~ 0.8 MJ/day, and in a randomized, placebo-controlled, 24-week, Phase III study, corresponding reductions in the need for parenteral support were obtained. EXPERT OPINION: Teduglutide seems to be safe and well-tolerated and demonstrates restoration of structural and functional integrity of the remaining intestine with significant intestinotrophic and proabsorptive effects, facilitating a reduction in diarrhea and an equivalent reduction in the need for parenteral support in SBS-IF patients.

AB - INTRODUCTION: Parenteral support is lifesaving in short bowel syndrome patients with intestinal failure (SBS-IF), who are unable to compensate for their malabsorption by metabolic or pharmacologic adaptation. Mutually, the symptoms of SBS-IF and the inconveniences and complications in relation to parenteral support may cause impairment of the quality of life of SBS-IF patients. Conventional treatments include dietary manipulations, oral rehydration solutions, antidiarrheal and antisecretory treatments. However, the evidence base for these interventions is limited, and treatments improving structural and functional integrity of the remaining intestine are desired. Teduglutide , an analog of glucagon-like peptide 2, improves intestinal rehabilitation by promoting mucosal growth and possibly by inhibiting gastric emptying and secretion, which in turn reduces intestinal losses and promotes intestinal absorption. AREAS COVERED: This paper reviews the following findings: in a 3-week, Phase II balance study, teduglutide reduced diarrhea by ~ 700 g/day and fecal energy losses by ~ 0.8 MJ/day, and in a randomized, placebo-controlled, 24-week, Phase III study, corresponding reductions in the need for parenteral support were obtained. EXPERT OPINION: Teduglutide seems to be safe and well-tolerated and demonstrates restoration of structural and functional integrity of the remaining intestine with significant intestinotrophic and proabsorptive effects, facilitating a reduction in diarrhea and an equivalent reduction in the need for parenteral support in SBS-IF patients.

KW - Gastrointestinal Agents

KW - Glucagon-Like Peptide 2

KW - Humans

KW - Peptides

KW - Short Bowel Syndrome

U2 - 10.1517/14656566.2012.644787

DO - 10.1517/14656566.2012.644787

M3 - Journal article

C2 - 22224470

SN - 1465-6566

VL - 13

SP - 235

EP - 243

JO - Expert Opinion on Pharmacotherapy

JF - Expert Opinion on Pharmacotherapy

IS - 2

ER -