Gastroenterology and Nutritional Support Department, Hôpital Beaujon, Clichy, France; Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France.
Pathology Department, Hôpital Beaujon, Clichy, France.
Am J Clin Nutr. 2023 Jun;117(6):1143-1151. doi: 10.1016/j.ajcnut.2023.02.015. Epub 2023 May 3.
Teduglutide is a GLP-2 analog indicated for the treatment of short bowel syndrome (SBS) since 2015. Its efficacy in reducing parenteral nutrition (PN) has been shown in patients with SBS.
Because teduglutide is a trophic factor, the aim of this study was to assess risk of developing polypoid intestinal lesions during treatment.
A retrospective study was conducted in 35 patients with SBS treated with teduglutide for ≥1 y in a home PN expert center. All patients underwent ≥1 follow-up intestinal endoscopy during treatment.
In the 35 patients, the small bowel length was 74 cm (IQR: 25-100), and 23 patients (66%) had a colon in continuity. Upper and lower gastrointestinal endoscopy was performed after a mean treatment duration of 23 mo (IQR: 13-27), and polypoid lesions were found in 10 patients (6 with a colon in continuity, 4 with an end jejunostomy) and no lesion in 25 patients. In 8 out of the 10 patients, the lesion was found in the small bowel. Five of these lesions presented an aspect of hyperplastic polyp without dysplasia, and 3 of a traditional adenoma with low-grade dysplasia.
Our study highlights the importance of performing follow-up upper and lower gastrointestinal endoscopy in SBS patients treated with teduglutide and the potential need to make changes to the recommendations with respect to treatment initiation and follow-up.
特迪格鲁肽是一种 GLP-2 类似物，自 2015 年以来被批准用于治疗短肠综合征（SBS）。它在 SBS 患者中减少肠外营养（PN）的疗效已得到证实。
由于特迪格鲁肽是一种营养因子，本研究旨在评估治疗过程中发生息肉样肠损伤的风险。
对在家庭 PN 专家中心接受特迪格鲁肽治疗≥1 年的 35 例 SBS 患者进行回顾性研究。所有患者在治疗期间均接受了≥1 次随访肠道内镜检查。
在 35 例患者中，小肠长度为 74cm（IQR：25-100），23 例（66%）患者存在连续性结肠。在上、下消化道内镜检查后，平均治疗时间为 23 个月（IQR：13-27），10 例患者（6 例连续性结肠，4 例空肠造口术）发现息肉样病变，25 例患者无病变。在 10 例患者中的 8 例中，病变位于小肠。其中 5 例病变呈增生性息肉，无异型增生，3 例呈传统腺瘤伴低级别异型增生。
我们的研究强调了在接受特迪格鲁肽治疗的 SBS 患者中进行上、下消化道内镜随访的重要性，并且可能需要对治疗开始和随访的建议进行更改。
