Billiauws Lore, Bataille Julie, Boehm Vanessa, Corcos Olivier, Joly Francisca
a Hopital Beaujon - Department of Gastroenterology and Nutrition Support , APHP - University Paris VII , Clichy , France.
b Hopital Beaujon - Department of Pharmacy , APHP - University Paris VII , Clichy , France.
Expert Opin Biol Ther. 2017 May;17(5):623-632. doi: 10.1080/14712598.2017.1304912.
The European Society for Clinical Nutrition has published recommendations on the 'definition and classification of intestinal failure (IF)'. Two criteria must be present: a 'decreased absorption of macronutrients and/or water and electrolytes due to a loss of gut function' and the 'need for parenteral support'. Home parenteral support (HPS) is the primary treatment for chronic IF but is associated with complications. Areas covered: The principal cause of chronic IF is short bowel syndrome (SBS). The aim of treatment is to maximize intestinal absorption and reduce or eliminate the need for HPS to achieve the best possible quality of life. Teduglutide, an analog of glucagon-like peptide 2, improves intestinal rehabilitation by promoting mucosal growth, reducing intestinal loss and promoting intestinal absorption. This article provides an overview and opinion on teduglutide for SBS. Expert opinion: Teduglutide may provide a new treatment strategy for SBS patients with chronic IF. When prescribed, patients should be informed of the benefits and risks of the drug and must be closely monitored in an expert center. Furthermore, as this treatment is costly, cost-effectiveness analysis as well as the risk-benefit ratio needs to be better evaluated.
欧洲临床营养学会发布了关于“肠衰竭（IF）的定义和分类”的建议。必须具备两个标准：一是“由于肠道功能丧失导致大量营养素和/或水及电解质吸收减少”，二是“需要肠外支持”。家庭肠外支持（HPS）是慢性IF的主要治疗方法，但会引发并发症。涵盖领域：慢性IF的主要病因是短肠综合征（SBS）。治疗目的是最大限度地提高肠道吸收能力，减少或消除对HPS的需求，以实现尽可能最佳的生活质量。替度鲁肽是一种胰高血糖素样肽2类似物，通过促进黏膜生长、减少肠道丢失和促进肠道吸收来改善肠道康复。本文对替度鲁肽治疗SBS进行了概述并发表了观点。专家意见：替度鲁肽可能为患有慢性IF的SBS患者提供一种新的治疗策略。开药时，应告知患者该药物的益处和风险，且必须在专家中心进行密切监测。此外，由于这种治疗费用高昂，需要更好地评估成本效益分析以及风险效益比。
