Jiao P, Zhang ZJ, Jiang Y, Zhou J, Deng KH, Zhu WX, Zhao XY, Guo ZK. Impact of teduglutide on pediatric short bowel syndrome: A systematic review and trial sequential meta-analysis. World J Gastrointest Surg 2025; 17(12): 112685 [DOI: 10.4240/wjgs.v17.i12.112685]
Corresponding Author of This Article
Zhao-Kun Guo, MD, Department of Pediatric Surgery, Yichang Central People's Hospital Affiliated to China Three Gorges University, No. 183 Yiling Road, Yichang 443003, Hubei Province, China. 12893437@qq.com
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Gerontology
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Meta-Analysis
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 27, 2025 (publication date) through Dec 25, 2025
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World Journal of Gastrointestinal Surgery
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1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Jiao P, Zhang ZJ, Jiang Y, Zhou J, Deng KH, Zhu WX, Zhao XY, Guo ZK. Impact of teduglutide on pediatric short bowel syndrome: A systematic review and trial sequential meta-analysis. World J Gastrointest Surg 2025; 17(12): 112685 [DOI: 10.4240/wjgs.v17.i12.112685]
World J Gastrointest Surg. Dec 27, 2025; 17(12): 112685 Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.112685
Impact of teduglutide on pediatric short bowel syndrome: A systematic review and trial sequential meta-analysis
Pan Jiao, Zhong-Jing Zhang, Ying Jiang, Jun Zhou, Ke-Heng Deng, Wen-Xiang Zhu, Xiang-You Zhao, Zhao-Kun Guo
Pan Jiao, Zhong-Jing Zhang, Ying Jiang, Jun Zhou, Ke-Heng Deng, Wen-Xiang Zhu, Xiang-You Zhao, Zhao-Kun Guo, Department of Pediatric Surgery, Yichang Central People's Hospital Affiliated to China Three Gorges University, Yichang 443003, Hubei Province, China
Author contributions: Jiao P and Guo ZK conceptualized and designed the study; Zhang ZJ drafted the manuscript; Jiang Y, Zhou J searched relevant databases; Deng KH and Zhu WX conducted literature screening and data extraction; Pan J and Zhao XY assessed the risk of bias; Zhang ZJ and Zhou J prepared tables and figures; Pan J resolved discrepancies and revised the manuscript; Guo ZK proofread the manuscript and improved English writing; Pan J is the guarantor for the overall content. All authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no competing financial interests or personal relationships that may have influenced the work reported in this study.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhao-Kun Guo, MD, Department of Pediatric Surgery, Yichang Central People's Hospital Affiliated to China Three Gorges University, No. 183 Yiling Road, Yichang 443003, Hubei Province, China. 12893437@qq.com
Received: August 4, 2025 Revised: September 24, 2025 Accepted: October 22, 2025 Published online: December 27, 2025 Processing time: 144 Days and 11.8 Hours
Abstract
BACKGROUND
Pediatric short bowel syndrome (SBS) poses management challenges, and teduglutide is a potential therapy. However, comprehensive data on its pediatric safety are lacking.
AIM
To evaluate the impact of teduglutide on infection and gastrointestinal adverse events in pediatric SBS patients via systematic review and meta-analysis.
METHODS
Following PRISMA 2009 guidelines and PROSPERO registration, we searched PubMed, Web of Science, and EMBASE for randomized controlled trials (RCTs) (pediatric SBS patients ≤ 18 years; teduglutide vs placebo/standard care). Two reviewers screened studies, extracted data, and assessed bias (ROB2). Meta-analyses used RevMan 5.4 (Mantel-Haenszel method, random-effects if I2 ≠ 0). Trial sequential analysis and GRADE were applied.
RESULTS
Three RCTs involving 115 pediatric patients were included. Pooled analysis revealed no statistically significant differences between the teduglutide and control groups for the primary outcome of infection events [RR = 0.83; (95%CI: 0.44-1.56); P = 0.57; I2 = 0%; 2 studies, n = 55]. Similarly, no significant differences were found for secondary outcomes: Upper respiratory tract infection [RR = 0.68; (95%CI: 0.32-1.47); P = 0.33; I2 = 0%], catheter site infection [RR = 1.86; (95%CI: 0.23-14.78); P = 0.56; I2 = 0%], vomiting [RR = 1.35; (95%CI: 0.10-18.23); P = 0.82; I2 = 72%], abdominal pain [RR = 2.47; (95%CI: 0.50-12.16); P = 0.27; I2 = 0%], nausea [RR = 1.31; (95%CI: 0.24-7.22); P = 0.75; I2 = 0%], diarrhea [RR = 1.02; (95%CI: 0.23-4.43); P = 0.98; I2 = 0%], and abdominal distension [RR = 1.49; (95%CI: 0.18-12.35); P = 0.71; I2 = 0%]. The overall certainty of evidence assessed by GRADE was moderate.
CONCLUSION
Teduglutide does not increase infection or gastrointestinal adverse event risk in pediatric SBS, but small sample sizes limit conclusions. Larger studies are needed.
Core Tip: This study evaluates the safety of teduglutide in pediatric short bowel syndrome via systematic review and trial sequential analysis. Three randomized controlled trials (n = 115) show no significant increase in infections or gastrointestinal adverse events, but small sample sizes limit conclusions. Larger, long-term studies are needed.
