Three-year experience with GLP-2 analog in intestinal rehabilitation for pediatric-onset short bowel syndrome.

Abstract

Purpose: To evaluate the impact of three-year Glucagon-like peptide 2 (GLP-2) analog therapy on parenteral nutrition (PN) dependency, intestinal rehabilitation, and quality of life in pediatric-onset short bowel syndrome (SBS).

Methods: Between August 2021 and December 2024, 18 pediatric-onset SBS patients underwent GLP-2-based intestinal rehabilitation. The remaining length of the small intestine ranged from 20 to 50 cm in adults and averaged 20 cm in children. Clinical data were retrospectively analyzed over a three-year period.

Results: PN requirements in adults decreased by up to 54.6%, with one patient achieving PN independence. Paediatric patients showed gradual reductions of up to 31.9%. Serum citrulline levels improved, suggesting enhanced intestinal adaptation. Stool consistency improved in all patients, and stool frequency decreased in six patients. PN duration per week decreased in eight patients, with one paediatric patient successfully being weaned off PN. All patients maintained social participation, though six children required special educational support due to ongoing PN　use. No intestinal polyps were detected, and any adverse events were mild and self-limiting.

Conclusions: GLP-2 analog therapy, which is based on intestinal rehabilitation, contributed to a sustained reduction in PN and enhanced clinical outcomes over three years, particularly in adult SBS patients. Continuous GLP-2 analog therapy might improve quality of life in paediatric-onset SBS.