Six-month outcomes of teduglutide treatment in adult patients with short bowel syndrome with chronic intestinal failure: A real-world French observational cohort study

Joly, Francisca; Séguy, D.; Nuzzo, Alexandre; Chambrier, C.; Beau, Philippe; Poullenot, Florian; Thibault, Ronan; Debeir, L. Armengol; Layec, S.; Boehm, Vanessa; Lallemand, J.; Quilliot, Didier; Schneider, Stéphane

doi:10.1016/j.clnu.2019.12.019

Cited by 45 publications

(72 citation statements)

References 24 publications

(28 reference statements)

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“…An accurate title or abstract revision was sufficient to exclude 401 articles as not pertinent or not fulfilling our prespecified inclusion or exclusion criteria. The remaining 34 studies were assessed in full-text for eligibility; 10 of them finally met all criteria for being included in the final analysis [27,28,[43][44][45][46][47][48][49][50]; 2 additional post hoc analyses were employed for data extraction [35,37], as they contained additional and relevant information for the assessment of the outcomes of 3 among the 10 pertinent papers [28,45,49]. The process of study selection is summarized in Figure 1.…”

Section: Search Resultsmentioning

confidence: 99%

Efficacy of Teduglutide for Parenteral Support Reduction in Patients with Short Bowel Syndrome: A Systematic Review and Meta-Analysis

et al. 2022

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Teduglutide has been described as an effective treatment for parenteral support (PS) reduction in patients with short bowel syndrome (SBS). However, a quantitative summary of the available evidence is still lacking. PubMed/Medline, EMBASE, Cochrane library, OVID, and CINAHL databases were systematically searched up to July 2021 for studies reporting the rate of response (defined as a ≥20% reduction in PS) to teduglutide among PS-dependent adult patients. The rate of weaning (defined as the achievement of PS independence) was also evaluated as a secondary end-point. Ten studies were finally considered in the meta-analysis. Pooled data show a response rate of 64% at 6 months, 77% at 1 year and, 82% at ≥2 years; on the other hand, the weaning rate could be estimated as 11% at 6 months, 17% at 1 year, and 21% at ≥2 years. The presence of colon in continuity reduced the response rate (−17%, 95%CI: (−31%, −3%)), but was associated with a higher weaning rate (+16%, 95%CI: (+6%, +25%)). SBS etiology, on the contrary, was not found to be a significant predictor of these outcomes, although a nonsignificant trend towards both higher response rates (+9%, 95%CI: (−8%, +27%)) and higher weaning rates (+7%, 95%CI: (−14%, +28%)) could be observed in patients with Crohn’s disease. This was the first meta-analysis that specifically assessed the efficacy of teduglutide in adult patients with SBS. Our results provide pooled estimates of response and weaning rates over time and identify intestinal anatomy as a significant predictor of these outcomes.

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Section: Search Resultsmentioning

confidence: 99%

Efficacy of Teduglutide for Parenteral Support Reduction in Patients with Short Bowel Syndrome: A Systematic Review and Meta-Analysis

et al. 2022

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“…Teduglutide enhances post-resection intestinal adaptation in SBS by stimulating intestinal mucosal growth and slowing gastrointestinal transit time, thus increasing intestinal absorption and decreasing intestinal losses in patients with SBS [14e18]. The response to treatment with teduglutide, with the consequent reduction in IVS requirements, has been shown to be greater in SBS-IF with the highest baseline IVS volume requirement [19,20] and in those with SBS-J [19]. Furthermore, the decision to use teduglutide in SBS-IF due to CD, the main cause of SBS-J in the present study, must take into account associated therapeutic precautions related to the presence of active disease, fistulas, strictures and the concomitant use biologic drugs [5,21].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome: An international multicenter survey

Jeppesen

Lee

Olveira

et al. 2021

Clinical Nutrition ESPEN

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Background and aims: The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries. Methods: The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorized as <1, 1e2, 2e3 and >3 L/day. Results: In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused !5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland. Conclusions: SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS.

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“…This highlights the need for patient-centred care, involving clinicians taking time to understand what is important to a particular patient and their goals [39]. As tedglutide has moved from being used in clinical trials to the real life setting patientcentred care and shared decision making to start the treatment are vital [40,41], not least because patients may have unachievable expectations which need discussing before they embark on a therapy. In addition, patients did not find it a straight forward decision and need to balance their preferences against the risks of the treatment.…”

Section: Discussionmentioning

confidence: 99%

Glucagon-like peptide 2 analogues in the treatment of intestinal failure: A qualitative exploration of the views of patients and their families in decision making

Sowerbutts

Burden

Griffiths

et al. 2021

Clinical Nutrition ESPEN

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Background and aims: Patients with short bowel syndrome and type 3 intestinal failure (SBS-IF) are dependent on parenteral nutrition (PN), a lifesaving treatment but inconvenient and with risks. Glucagon-like peptide 2 analogue (teduglutide) can reduce patients' need for PN. However, it comes with the risk of a number of side effects. This qualitative study investigated patients' decision making process to start teduglutide and how family members contributed to the decision. Methods: In-depth semi-structured interviews were conducted with nine participants, six patients with SBS-IF and three family members about the decision to take teduglutide. Interviews were transcribed verbatim and analysed using framework analysis. Results: The prominent motivation for taking teduglutide (Revestive® Takeda Pharmaceuticals Limited) was reducing or stopping PN. Other motivations were to help others by assisting in developing the knowledge base around teduglutide, patients felt that they had nothing to lose by trying the drug and the support of relatives. The reasons patients considered not taking the drug were that they had accepted being on PN, the potential side effects of teduglutide and undergoing extra monitoring. However, the monitoring programme also acted as a motivator providing reassurance that patients would be observed and supported with side effects. Family members were happy to support patients' decision to try teduglutide, although they had more reservations, indicating a higher risk threshold. Conclusion: Patients considered potential benefits of teduglutide outweighed any disadvantages. Relatives, although supportive, had more reservations.

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Six-month outcomes of teduglutide treatment in adult patients with short bowel syndrome with chronic intestinal failure: A real-world French observational cohort study

Cited by 45 publications

References 24 publications

Efficacy of Teduglutide for Parenteral Support Reduction in Patients with Short Bowel Syndrome: A Systematic Review and Meta-Analysis

Efficacy of Teduglutide for Parenteral Support Reduction in Patients with Short Bowel Syndrome: A Systematic Review and Meta-Analysis

Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome: An international multicenter survey

Glucagon-like peptide 2 analogues in the treatment of intestinal failure: A qualitative exploration of the views of patients and their families in decision making

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