Department of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Vienna, Austria.
Department of Internal Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.
JPEN J Parenter Enteral Nutr. 2022 Feb;46(2):300-309. doi: 10.1002/jpen.2272. Epub 2021 Oct 21.
The glucagon-like peptide 2 analogue teduglutide is an effective drug for the treatment of short bowel syndrome patients with intestinal failure (SBS-IF). This intestinotrophic peptide improves intestinal capacity for fluid and nutrient absorption through induction of mucosal growth and reduction of gastrointestinal motility. Clinical trials demonstrated the efficacy of teduglutide in reducing the need for parenteral support (PS). This study describes an SBS-IF patient population receiving teduglutide therapy in a specialized medical care setting.
A retrospective analysis was performed using data of patients experiencing nonmalignant SBS-IF. They were treated with teduglutide in a multidisciplinary SBS-IF program at a single university medical center between June 2016 and June 2020.
Thirteen patients under teduglutide treatment were included in the final analysis. Mean small bowel length was 82 ± 31 cm, with 77% of patients having their colon in continuity. Over a median follow-up of 107 weeks, all patients (13 of 13, 100%) responded to the therapy with a clinically significant reduction of PS volume. Mean PS reduction increased with therapy duration and ranged from -82.5% at week 24 (n = 13) to -100% in patients (n = 5) who were treated for 144 weeks. Enteral autonomy was achieved in 12 of 13 (92%) patients. Teduglutide therapy improved stool frequency and consistency, changed dietary habits, and reduced disease-associated sleep disruptions.
Integrating SBS-IF patients treated with teduglutide in a proactive and tight-meshed patient care program significantly improves the clinical outcome, leading to an increased proportion of patients reaching enteral autonomy.
胰高血糖素样肽 2 类似物特迪格鲁肽是治疗肠衰竭相关短肠综合征（SBS-IF）患者的有效药物。这种肠营养肽通过诱导黏膜生长和减少胃肠动力来提高肠道对液体和营养物质的吸收能力。临床试验证明了特迪格鲁肽在减少肠外营养（PN）支持需求方面的疗效。本研究描述了在专门医疗环境中接受特迪格鲁肽治疗的 SBS-IF 患者人群。
使用经历非恶性 SBS-IF 的患者数据进行回顾性分析。他们在单一大学医疗中心的多学科 SBS-IF 项目中接受特迪格鲁肽治疗，时间为 2016 年 6 月至 2020 年 6 月。
最终分析纳入了 13 名接受特迪格鲁肽治疗的患者。平均小肠长度为 82±31cm，77%的患者结肠连续存在。在中位随访 107 周期间，所有患者（13/13，100%）对治疗有反应，PN 量明显减少。PN 减少的平均幅度随治疗时间而增加，在接受 24 周治疗的 13 名患者（n=13）中为-82.5%，在接受 144 周治疗的 5 名患者（n=5）中为-100%。13 名患者中的 12 名（92%）实现了肠内自主。特迪格鲁肽治疗改善了粪便频率和稠度，改变了饮食习惯，并减少了与疾病相关的睡眠障碍。
在积极主动和紧密协调的患者护理计划中整合接受特迪格鲁肽治疗的 SBS-IF 患者显著改善了临床结局，使更多患者达到肠内自主。
