Teduglutide in Adult Patients with Chronic Intestinal Failure due to Short Bowel Syndrome: Treatment Protocol Based on Expert Recommendations

Authors

  • Héctor Solar Hospital Universitario Fundación Favaloro, City of Buenos Aires.
  • Adriana Crivelli Hospital San Martín, La Plata, Buenos Aires.
  • Silvia de Barrio Hospital San Martín, La Plata, Buenos Aires.
  • Martin Buncuga Hospital Escuela Eva Perón, Granadero Baigorria, Santa Fe.
  • Alejandra Manzur Clínica de Cuyo, Mendoza.

DOI:

https://doi.org/10.52787/agl.v52i1.168

Keywords:

Type III intestinal failure, chronic intestinal failure, short bowel syndrome, parenteral nutrition, enterohormones, GLP2, teduglutide, intestinal rehabilitation, intestinal transplant

Abstract

Chronic intestinal failure due to short bowel syndrome is a severe and complex disease that requires specialized multidisciplinary treatment. Parenteral nutrition is the fundamental support in these patients; however, in the long term, complications associated with it may develop that contraindicate its continuity. In this context, an isolated or combined intestinal transplant (liver-intestine) is the last alternative to recover intestinal sufficiency. Since 2012 was introduced in the world, the use of semisynthetic GLP2 peptide, called teduglutide, changed the course and prognosis of this disease. Argentina is the Latin American country with the most experience in the use of this enterohormone, with results comparable to those of other international centers. This article summarizes the expert recommendations for the use of teduglutide in patients with chronic intestinal failure due to short bowel syndrome.

References

- 1. Pironi L, Arends J, Baxter J, et al. ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults. Clinical Nutrition. 2015;34:171-80.

- 2. Pironi L, Konrad D, Brandt C, et al. Clinical classification of adult patients with chronic intestinal failure to benign disease: An international multicenter cross-sectional survey. Clinical Nutrition. 2018;37:728-38.

- 3. Gondolesi G, Doeyo M, Echevarria C, et al. Results of Surgical and medical rehabilitation for adult patients with type III intestinal failure in a comprehensive unit today: Building a new model to predict parenteral nutrition independency. Journal of Parenteral and Enteral Nutrition. 2019;44(4):703-13.

- 4. Pironi L, Konrad D, Brandt C, et al. Clinical classification of adult patients with chronic intestinal failure due to benign disease: An international multicenter cross-sectional survey. Clin Nutr. 2018;37(2):728-38.

- 5. Gondolesi G, Ramisch D, Padin J, et al. What is the normal small bowel length in humans? First donor-based cohort analysis. American journal of Transplantation. 2012;12:S49-S54.

- 6. Messing B, Crenn P, Beau P, et al. Long-term survival and Parenteral Nutrition Dependence in Adult Patients with the short Bowel Syndrome. Gastroenterology. 1999;117:1043-50.

- 7. Amiot A, Messing B, Corcos O, et al. Determinants of home parenteral nutrition dependence and survival of 268 patients with non-malignant short bowel syndrome. Clinical Nutrition. 2013;32:368-74.

- 8. Wilmore DW, Dudrick SJ. Growth and development of an infant receiving all nutrients exclusively by vein. JAMA. 1968;203:860-4.

- 9. Abu-Elmagd, KM. The history of intestinal transplantation. In History of organ and cell transplantation. 2003:171-93.

- 10. Grant D, Abu Elmagd KM, Mazariegos G, et al. Intestinal transplant registry report: global activity and trends. Am J Transplant. 2015;15:210-9.

- 11. Ramisch D, Rumbo C, Echevarría C, et al. Long term outcomes of intestinal and multivisceral transplantation at a single center in Argentina. Transplantation Preoceeding. 2015;48(2):457-62.

- 12. Gondolesi G, Doeyo M, Solar H. A detailed analysis of the current status of intestinal transplantation in Latin America. Curr Opin OrganTransplant. 2020;25:189-95.

- 13. Gondolesi G, Pattin F, Nikkoupur H. Management of intestinal failure in middle-income countries, for children and adults. Curr Opin Organ Transplant. 2018,23:212-8.

- 14. Sudan D, DiBaise J, Torres C, et al. A multidisciplinary approach to the treatment of intestinal failure. J. Gastrointest Surg. 2005;9:165-76.

- 15. Fishbein TM, Schiano T, Le Leiko N, et al. An integrated approach to intestinal failure: results of a new program with total parenteral nutrition, bowel rehabilitation and transplantation. J Gastrointest Surg. 2002; 6:554-62.

- 16. Körner M. Interprofessional teamwork in medical rehabilitation: a comparison of multidisciplinary and interdisciplinary team approach. Clinical Rehabilitation. 2010;24:745-55.

- 17. Grainger J, Maeda Y, Donnelly S, et al. Assessment and management of patients with intestinal failure: a multidisciplinary approach. Clinical and Experimental Gastroenterology. 2018;11:233-41.

- 18. Jung SM, Lee S, Park HJ, et al. Multidisciplinary intestinal rehabilitation in acute type II intestinal failure: Results from an intestinal rehabilitation team. Asian Journal of Surgery. 2021;44(3),549-52.

- 19. Bianchi A. Intestinal loop lengthening-a technique for increasing small intestinal length. J Pediatr Surg. 1980;15:145-51.

- 20. Kim HB, Fauza D, Garza J, et al. Serial transverse enteroplasty (STEP): A novel bowel lengthening procedure. J Pediatr Surg. 2003;38:425-9.

- 21. Cserni T, Takayasu H, Muzsnay Z, et al. New idea of intestinal lengthening and tailoring. Pediatr SurgInt. 2011;27:1009-13.

- 22. Pironi L, Arends J, Bozzetti, et al. ESPEN guidelines on chronic intestinal failure in adults. Clinical Nutrition 2016;35:247-307.

- 23. Jeppensen P. Spectrum of short bowel syndrome in adult: Intestinal insufficiency to intestinal failure. JPEN. 2014;38:8S-13S.

- 24. Tappenden K Patophysiology of short bowel syndrome: considerations of resected and residual anatomy. JPEN. 2014;38:14S-22S.

- 25. Drucker Daniel J, Ehrlich Peter, Asa Sylvia L, et al. Induction of intestinal epithelial proliferation by glucagon-like peptide 2. Proc Natl. Acad. Sci. USA Vol 93, pp 7911-7916 July 1996.

- 26. Drucker Daniel J, Yusta Bernardo. Physiology and Pharmacology of the Enteroendocrine Hormone Glucagon like Peptide-2. Annu. Rev. Physiol. 2014;76:561-83.

- 27. Drucker Daniel J. The discovery of GLP-2 and Development of Teduglutide for Short Bowel Syndrome. ACS Pharmacol. Transl. Sci. 2019;2:134-42.

- 28. Jeppesen PB, Pertkiewicz M, Messin B, et al. Teduglutide reduces need for parenteral support among patients with short bowel syndrome with intestinal failure. Gastroenterology. 2012;143(6):1473-81.

- 29. Schwartz LK, O’Keefe SJ, Fujioka K, et al. Long term Teduglutide for the treatment of patients with intestinal failure associated with short bowel syndrome. Clin Transl Gastroenterol. 2016;7:e142.

- 30. Jeppesen PB, Pertkiewicz M, Messing B, et al. Teduglutide reduces need for parenteral support among patients with shot bowel syndrome with intestinal failure. Gastroentology. 2012;143(6):1473-81.

- 31. Schwartz LK, O’Keefe SJ, Fujioka K, et al. Long term Teduglutide for the treatment of Patients with Intestinal Failure Associated with Short Bowel Syndrome. Clin Transl Gastroenterol. 2016;7:e142.

- 32. Seidner Douglas L, Fujiota K, Boullata J, et al. Reduction of parenteral nutrition and hydration support and safety with long term Teduglutide treatment in patients with short bowel syndrome associated intestinal failure: STEPS-3 study. Nutritional in Clinical Practice. 2018Apr:1-8.

- 33. Lam K, Scwartz L, Batidti J, et al. Single Center Experience with the Use of Teduglutide in Adult Patients with Short Bowel Syndrome. JPEN Vol 42 (1). January 2018:225-30.

- 34. Joly F, Seguy D, Nuzzo A, et al. Six month outcomes of teduglutide treatment in adult patients with short bowel syndrome with chronic intestinal failure: A real-world French observational cohort study. Clinical Nutrition. 2020; 39(9): 2856-2862.

- 35. Pevny S, Maasberg S, Rieger A, et al. Experience with teduglutide treatment for short bowel syndrome in clinical practice. Clinical Nutrition. 2018:1-11.

- 36. Solar H, Doeyo M, Ortega M, et al. Postsurgical Intestinal Rehabilitation Using Semisynthetic Glucagon-Like Peptide-2 Analogue (sGLP-2) at a Referral Center: Can Patients Achieve Parenteral Nutrition and sGLP-2 Independency? JPEN. 2020;45(5):1072-82.

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Published

2022-03-30

How to Cite

Solar, H., Crivelli, A., de Barrio, S., Buncuga, M., & Manzur, A. (2022). Teduglutide in Adult Patients with Chronic Intestinal Failure due to Short Bowel Syndrome: Treatment Protocol Based on Expert Recommendations. Acta Gastroenterológica Latinoamericana, 52(1), 47–56. https://doi.org/10.52787/agl.v52i1.168

Issue

Vol. 52 No. 1 (2022): Acta Gastroenterológica Latinoamericana

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Copyright (c) 2022 Héctor Solar, Adriana Crivelli, Silvia de Barrio, Martin Buncuga, Alejandra Manzur

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