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Small bowel nutrition and intestinal failure
Original research
Real-world data on the use of teduglutide in a UK cohort: 4-year experience of a single centre
  1. Phil Stevens1,
  2. Rebecca Turner1,
  3. Graeme Doherty2,
  4. Dawn Jordan1,
  5. Fiona Leitch1,
  6. Linda Murray3,
  7. John Wadsworth1 Scottish Trace Element and Micronutrient Diagnostic and Research Laboratory
  1. 1 General Surgery, Glasgow Royal Infirmary, Glasgow, UK
  2. 2 Pharmacy, Glasgow Royal Infirmary, Glasgow, UK
  3. 3 Dietetics, Glasgow Royal Infirmary, Glasgow, UK
  1. Correspondence to Dr Phil Stevens; phil.stevens{at}ggc.scot.nhs.uk

Abstract

Background Phase IV outcome data of novel therapies in an orphan-disease need to be shared. Glucagon-like peptide-2 (GLP-2) analogues for short bowel syndrome chronic intestinal failure (SBS-cIF) were approved for use in NHS Scotland in 2020. The aim of this study was to report early experience introducing GLP-2 to a specialist intestinal failure service.

Method Retrospective analysis of a patient database was used to describe changes in home parenteral support (HPS), patient tolerance and micronutrient balance following introduction of GLP-2 analogue. These were compared with changes in HPS patients weaned by adaptation, surgery or transplantation.

Results Of 218 patients managed with HPS at the Glasgow Royal Infirmary between February 2020 and August 2024, 162 (74%) had SBS-cIF. 70 (43%) met inclusion criteria for teduglutide. 11 (15%) received teduglutide, with median dose of 3.0 mg/day during the study period. Overall, 8 (73%) achieved reduction of one or more nights HPS/week and 7 (64%) either an HPS reduction >1.5 L/day or >20% reduction in equivalent daily volumes at 6 months. 6 (55%) retained teduglutide use long term. Patients weaned from HPS with teduglutide compared with those weaned by other means had significantly better liver enzymes, vitamin C and manganese. Indices of renal function may reflect change in lean body mass. Significantly more teduglutide weaned patients had end jejunostomies.

Conclusion GLP-2 analogue use reduced parenteral support requirement when integrated into our intestinal failure service. These treatments may have extra-enteric hepatoprotective consequences.

  • INTESTINAL FAILURE
  • PARENTERAL NUTRITION
  • SHORT BOWEL SYNDROME
  • GASTROINTESTINAL HORMONES

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/flgastro-2024-102689

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Contributors PS: lead author and guarantor, data collection, project supervisor (guarantor). RT: data collection, manuscript review. GD: manuscript review, pharmacy advisor. DJ: manuscript review. FL: manuscript review. LM: manuscript review, dietetic advisor. JW: manuscript review, trace element and micronutrient advisor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests PS and RT have previously received funding from Takeda. DJ, LM, FL, GD and JW have no competing interests to declare with regard to this publication.

    • Provenance and peer review Commissioned; externally peer-reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.