P-42: Experience With Teduglutide of a Single Center in Pediatric Short Bowel Syndrome

Introduction: Short bowel syndrome (SBS) is the leading cause of intestinal failure in children. After the resection, the remnant intestine tries to increase absorption in order to recover homeostasis. Numerous growth factors have been implicated in this process. Glucagon-like-peptide-2 (GLP-2) is an endogenous growth factor strongly associated with intestinal growth and post-resection intestinal adaptation. Endogenous GLP-2 has a half live of 7 minutes and is degraded by dipeptidyl peptidase IV (DPPIV). Teduglutide is a GLP-2 analog with a substitution of alanine by glycine in position 2 that blocks DPPIV degradation. Experience with teduglutide in pediatric patients with SBS in a single Spanish hospital is described in this study. Methods: nineteen pediatric patients with intestinal failure secondary to short bowel syndrome are treated with teduglutide in our center. 3 of them less of 3 months, so only 16 were included in this study. Patients received 0.05 mg/kg/d of subcutaneous teduglutide. Demographics, parenteral nutrition (PN) requirements initially and at 3, 6 and 12 months and adverse events were recorded. Results: Children (12 months to 15 years) were receiving an average of 59 ml/Kg/d and 33 Kcal/kg/d of PN at baseline (2 patients received only fluid supplementation). 10 of 16 patients achieved PN independence: 3 patients were off PN at 3 months, 4 at 6 months, and 3 after more than 12 months. Two patients had their treatment stopped after one year because no reduction in PN requirements was achieved. Four patients had intravenous requirements reduced by 10 to 50%. Two patients suffered an episode of cholecystitis, and another one a cardiac decompensation. Conclusion: The results of our series (the first of a single center so far), shows promising data in short bowel syndrome prognosis. Teduglutide seems to be a safe and effective treatment in the pediatric SBS population. Teduglutide can be an alternative for PN-dependent patients in whom development of complications might lead to intestinal transplantation. At the moment, however, there is a lack of long term data with regards to the efficacy and safety of this intervention.