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

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.