Six-month Outcomes of Teduglutide Treatment in Adult Patients With Short Bowel Syndrome with Chronic Intestinal Failure: a real-world French observational cohort study

Summary Background & Aims Teduglutide, a GLP-2-analog, has proven effective in two placebo-controlled studies in reducing parenteral support (PS) in patients with short bowel syndrome-associated intestinal failure (SBS-IF) after 24 weeks. The aim of this study was to describe in a real-life situation the effects of teduglutide treatment and their predictive factors. Methods We included 54 consecutive SBS-IF patients treated with teduglutide in France for at least 6 months from 10 expert centers. Small bowel length was 62±6 cm and 65% had colon in continuity. PS was 4.4±.2 infusions per week, started 9.8±1.2 years before. Response (PS reduction ≥ 20%) and PS discontinuation rates were assessed at week 24. Adjusted p values of factors associated with response and weaning were calculated using a multivariate logistic regression model. Results At week 24, 85% of patients were responders and 24% had been weaned off PS, with a 51% reduction of PS needs and 1.5±0.2 days off PS per week. Response to teduglutide was influenced by a higher baseline oral intake (p=.02). Weaning off PS was influenced by the presence of colon (p=.04), a lower PS volume (p=.03) and a higher oral intake (p=.01). There were no differences based on age, bowel length or SBS-IF causes. Conclusions Our study confirms the effectiveness of teduglutide in reducing PS needs in SBS-IF patients. We associated reduced parenteral support volume with baseline parenteral volume support, bowel anatomy, and oral intake. These findings underline the role of nutritional optimization when starting the treatment.