Use of teduglutide in adults with short bowel syndrome–associated intestinal failure

Abstract

AbstractShort bowel syndrome (SBS) is a rare gastrointestinal disorder associated with intestinal failure (SBS‐IF) and poor health‐related outcomes. Patients with SBS‐IF are unable to absorb sufficient nutrients or fluids to maintain significantly metabolic homeostasis via oral or enteral intake alone and require long‐term intravenous supplementation (IVS), consisting of partial or total parenteral nutrition, fluids, electrolytes, or a combination of these. The goal of medical and surgical treatment for patients with SBS‐IF is to maximize intestinal remnant absorptive capacity so that the need for IVS support may eventually be reduced or eliminated. Daily subcutaneous administration of the glucagon‐like peptide 2 analog, teduglutide, has been shown to be clinically effective in reducing IVS dependence and potentially improving the health‐related quality of life of patients with SBS‐IF. The management of patients with SBS‐IF is complex and requires close monitoring. This narrative review discusses the use of teduglutide for patients with SBS‐IF in clinical practice. The screening of patient eligibility for teduglutide treatment, initiation, monitoring of efficacy and safety of treatment, adapting or weaning off IVS, and the healthcare setting needed for SBS‐IF management are described, taking into consideration data from clinical trials, observational studies, and clinical experience.