Real-world effectiveness and safety of teduglutide in patients with short bowel syndrome

Abstract

This Latin American research supported the use of teduglutide following the early identification of advantageous anatomy (partial colon in continuity) and reduced reliance on parenteral nutrition at baseline. The therapy was maintained for 24 weeks, with the evaluation commencing after 12 weeks of treatment, leading to total parenteral nutrition independence in 26.6% of patients. The reported adverse effects related to the treatment were minimal and aligned with those found in existing literature. Limitations of the study included limited patient recruitment, a lack of discussion regarding the actual treatment duration, no data on routine endoscopies/colonoscopies performed to detect tumor or polyp recurrence during treatment, and the cost implications of such treatment. In a recent article, the median time for adverse events to occur was 393 days (56 weeks). At the same time, the current study lasted 24 weeks, suggesting that theoretically, numerous adverse events may have gone unnoticed.

Keywords: Short bowel syndrome; Parenteral nutrition; Teduglutide; Diarrhea; Malabsorption syndromes

Core Tip: Teduglutide (rDNA) is a Food and Drug Administration sanctioned medication for individuals with short bowel syndrome. The majority of short bowel syndrome patients receive parenteral support, and this medication enhances their chances of achieving parenteral independence to different extents. Daily subcutaneous injections are routinely prescribed, along with regular gastrointestinal colonoscopies/endoscopies to observe the enterocyte dysplasia present in certain individuals. The expensive nature of the treatment significantly discourages its regular use, leading the prescribing physician to adjust its dosage. Nonetheless, only a limited number of treatment-related side effects are seen, making it the sole pharmacological choice for these patients.