医学
断奶
短肠综合征
内科学
队列
胃肠病学
肠外营养
前瞻性队列研究
养生
外科
作者
Dane Christina Daoud,Katherine J. P. Schwenger,Hyejung Jung,Wendy Lou,David Armstrong,Maitreyi Raman,James D. McHattie,Donald R. Duerksen,Scott Whittaker,Barbara Bielawska,Brian Jurewitsch,Leah Gramlich,Johane P. Allard
摘要
Abstract Background Teduglutide is a synthetic glucagon‐like peptide‐2 analogue approved for the treatment of short bowel syndrome associated with chronic intestinal failure (SBS‐IF) in adult patients. Clinical trials have demonstrated its ability to reduce parenteral support (PS) requirement. This study aimed to describe the effect of 18‐month treatment with teduglutide, evaluating PS and factors associated with PS volume reduction of ≥20% from baseline and weaning. Two‐year clinical outcomes were also assessed. Methods This descriptive cohort study collected data prospectively from adult patients with SBS‐IF treated with teduglutide and enrolled in a national registry. Data were collected every 6 months and included demographics, clinical, biochemical, PS regimen, and hospitalizations. Results Thirty‐four patients were included. After 2 years, 74% ( n = 25) had a PS volume reduction of ≥20% from baseline, and 26% ( n = 9) achieved PS independency. PS volume reduction was significantly associated with longer PS duration, significantly lower basal PS energy intake, and absence of narcotics. PS weaning was significantly associated with fewer infusion days, lower PS volume, longer PS duration, and lower narcotics use at baseline. Alkaline phosphatase was significantly lower in weaned patients after 6 and 18 months of treatment. During the 2‐year study duration, patients who had PS volume reduction of ≥20% had significantly fewer yearly hospitalizations and hospital‐days. Conclusions Teduglutide reduces PS volume and promotes weaning in adults with SBS‐IF. Lack of narcotics and longer PS duration were associated with PS volume reduction and weaning, and lower baseline PS volume and fewer infusion days were favorable in obtaining enteral autonomy.
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