Abstract
1.1 Background and Aims
Glucagon like peptide-2 (GLP-2) agonists have shown potential as an effective treatment option for parenteral nutrition (PN) in patients with short-bowel syndrome (SBS). However, a literature gap is present regarding its efficacy in reducing rates of PN volume and calories along with changed in biomarkers.
1.2 Methods
A systematic database search of MEDLINE, Google Scholar and Cochrane Library was performed from their inception till March 2024. The outcomes assessed were: changes in weekly PN volume, and daily PN calories, rate of weaning, wet fecal weight excretion, and a greater than 20% reduction in PN following the use of GLP-2 agonists. Outcomes were analyzed using a random effects model and presented as weighted mean differenced (WMD) along with their 95% CI.
1.3 Results
A total of 41 studies were included. Analysis of the pooled data displayed a statistically significant decrease in the weekly PN volume requirements by almost 5 liters per week with the use of GLP-2 agonists. Similarly, a significant decrease in the daily PN calorie requirement of approximately 360 kcal/day was also observed. The combined single-arm meta-analysis also revealed a one-third chance of PS weaning. Furthermore, the meta-analysis revealed a 72% chance of greater than 20% PN volume reduction with GLP-2 agonists, which was statistically significant.
1.4 Conclusions
This meta-analysis successfully demonstrated the potential efficacy of GLP-2 agonists in improving intestinal health and reducing PN requirements in patients with SBS. Our results provide pooled data pertaining to the reduction in PN volume and increased PN weaning rates along with significant improvements in overall nutritional outcomes.