Long-term teduglutide improves intestinal absorption in children with SBS

Treatment with teduglutide for 48 weeks results in increased intestinal absorption and decreased parenteral nutrition (PN) dependency in children with short bowel syndrome (SBS)-related intestinal failure (IF), as shown in a study.

The investigators included children with SBS (median age 9.4 years) followed at their centre with ≥2 years on PN and with small bowel length <80 cm who had reached a plateau. Participants underwent a clinical assessment at baseline, including a 3-day stool balance analysis, repeated at the end of study. Teduglutide 0.05 mg/kg/d was administered subcutaneously for 48 weeks.

PN dependence was expressed as PN dependency index (PNDI), which is the PN nonprotein energy intake/resting energy expenditure ratio. Treatment-emergent adverse events and growth parameters were the safety endpoints.

The children’s median residual small bowel length was 26 cm. Their mean PNDI at baseline was 94 percent (median PN intake, 38.9 calories/kg/day).

Twenty-four (96 percent) children had >20-percent decrease of PN requirements at week 24, with a median PNDI of 50 percent (PN intake, 23.5 calories/kg/day; p<0.01). Eight (32 percent) children were completely weaned off PN at week 48.

Plasma citrulline rose from 14 μmol/L at baseline to 29 μmol/L at week 4 (p<0.001), while weight, height, and body mass index z-scores remained stable. The median total energy absorption rate also increased from 59 percent at baseline to 73 percent at week 48 (p=0.0222). Compared with baseline, fasting and postprandial endogenous GLP-2 concentrations increased at weeks 24 and 48.

In terms of adverse events, children reported mild abdominal pain at the early phase of treatment, stoma changes, and redness at the injection site.