Teduglutide in adults with short bowel syndrome and intestinal failure: A descriptive cohort study.

Abstract

Background: International evidence supports the efficacy of teduglutide in reducing parenteral support requirements, or achieving enteral autonomy, in patients with short bowel syndrome-intestinal failure. This is a multicenter observational study presenting the real-world experience with teduglutide in Australia.

Materials and methods: 11 of 12 Australian intestinal rehabilitation units submitted data for 19 adult patients with short bowel syndrome-intestinal failure prescribed teduglutide from November 2020 to August 2023. Patient and clinical characteristics, including teduglutide dosing and parenteral support prescriptions, were collected at 3-month intervals for 12 months from teduglutide initiation and finally at study termination. Univariate analysis was conducted and results presented as medians with interquartile ranges (IQRs).

Results: Seventy-four percent of the cohort (median age 58 [IQR 44-67] years) were female. The median residual small bowel length was 85 cm (IQR 60-118), with 53% having colon in continuity. Prior to teduglutide commencement, median parenteral support duration was 3.8 (IQR 1.1-11.0) years, with weekly parenteral support volumes of 11.5 (IQR 6.2-15.3) L/week. Seven patients (37%) achieved enteral autonomy, with five weaned off by 12 months and the remaining between 12-42 months from teduglutide initiation. 79% achieved ≥20% parenteral support volume reductions, with overall median parenteral support volume reductions of 28% after 12 months. Baseline quality-of-life assessments suggested that sexual function, travel ability, and sleep patterns were areas of greatest disease burden.

Conclusion: Within an Australian cohort, teduglutide is effective at reducing parenteral support requirements in patients with short bowel syndrome-intestinal failure, although the effect onset and range remains heterogenous.