Safety and long-term effectiveness of teduglutide in children with intestinal failure due to short bowel syndrome: a multicenter, post-marketing cohort study.

IF 3.3 3区 医学 Q1 PEDIATRICS
Lissette Jimenez, Aliza Ray, David Mercer, Samuel Kocoshis, Sivan Kinberg, Mercedes Martinez, Lindsey Gumer, Russell Merritt, Mark R Corkins, Charles Vanderpool, Valeria Cohran, Danielle Wendel, John Thompson, Debra Sudan, Kristin Whitfield Van Buren, Stuart Kaufman, Alexandra N Carey, Sasan Sabrdaran, Paul Mitchell, Suzanne E Dahlberg, Edie Weller, Christopher P Duggan
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引用次数: 0

Abstract

Background: Teduglutide, a glucagon-like peptide-2 (GLP-2) analog, was approved in the US for use in children with intestinal failure dependent on parenteral support (PS, including intravenous fluids and/or parenteral nutrition (PN)) in 2019.

Methods: Between May 2021 and December 2022, we enrolled 140 children with intestinal failure in a multi-center registry across 14 centers to evaluate the long-term (up to 3 years) safety and effectiveness of teduglutide.

Results: Among 120 participants in whom effectiveness was measured, the mean percent reduction in parenteral calories was 8.3% by 6 months, 16.5% by 12 months, 33.0% by 2 years and 49.5% by 3 years, estimated by linear mixed models. Cumulative incidence estimates for weaning from parenteral support (full enteral autonomy) were 7.5% by 6 months, 15.2% by 1 year, 26.4% by 2 years, and 32.7% by 3 years from baseline. Five patients had inflammatory/foveolar polyps. The modeled proportion of children with low weight-for-age Z score increased from 2.3% at baseline to 12.7% at 3 years (p < 0.01) and mean BMI Z-scores declined over follow-up as well.

Conclusions: In children treated with teduglutide, we found a progressive and sustained reduction in parenteral support up to 3 years and recommend careful attention to the nutritional status of such patients.

Impact: The GLP-2 analog medication teduglutide was approved by the FDA in 2019 for children receiving parenteral support for intestinal failure. We enrolled 140 such children to evaluate its safety and effectiveness profile in a post-marketing study. Substantial reductions in parenteral calories and volume were noted with a reasonable safety profile. Some reductions in nutritional status (weight and BMI but not height) were also noted. Careful monitoring of nutritional status while on this new medication is warranted.

Clinical trial registry site: NCT04832087.

替杜鲁肽治疗短肠综合征所致肠衰竭患儿的安全性和长期有效性:一项多中心上市后队列研究
背景:Teduglutide是一种胰高血糖素样肽-2 (GLP-2)类似物,于2019年在美国被批准用于依赖肠外支持(PS,包括静脉输液和/或肠外营养(PN))的肠衰竭儿童。方法:在2021年5月至2022年12月期间,我们在14个中心的多中心登记中招募了140名肠衰竭儿童,以评估teduglutide的长期(长达3年)安全性和有效性。结果:在测量有效性的120名参与者中,通过线性混合模型估计,6个月时肠道外卡路里减少的平均百分比为8.3%,12个月时为16.5%,2年时为33.0%,3年时为49.5%。从基线开始,6个月时肠外支持(完全肠内自主)断奶的累积发生率估计为7.5%,1年为15.2%,2年为26.4%,3年为32.7%。5例患者有炎性/小窝息肉。低年龄体重Z评分儿童的模型比例从基线时的2.3%增加到3年后的12.7% (p)。结论:在接受特杜葡肽治疗的儿童中,我们发现肠外支持的持续减少持续至3年,并建议仔细关注这类患者的营养状况。影响:GLP-2类似药物teduglutide于2019年被FDA批准用于接受肠外支持治疗肠衰竭的儿童。我们招募了140名这样的儿童,在上市后研究中评估其安全性和有效性。肠道外热量和体积的大幅减少具有合理的安全性。营养状况(体重和身体质量指数,但不包括身高)也有所下降。在服用这种新药时,必须仔细监测营养状况。临床试验注册点:NCT04832087。
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来源期刊
Pediatric Research
Pediatric Research 医学-小儿科
CiteScore
6.80
自引率
5.60%
发文量
473
审稿时长
3-8 weeks
期刊介绍: Pediatric Research publishes original papers, invited reviews, and commentaries on the etiologies of children''s diseases and disorders of development, extending from molecular biology to epidemiology. Use of model organisms and in vitro techniques relevant to developmental biology and medicine are acceptable, as are translational human studies
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