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

Abstract

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.

• Authors: Fabio Bioletto, Chiara D'Eusebio, Fabio Dario Merlo, Umberto Aimasso, Marta Ossola, Marianna Pellegrini, Valentina Ponzo, Alessia Chiarotto, Antonella De Francesco, Ezio Ghigo, Simona Bo
• Journal: Nutrients (Nutrients) Vol. 14 Issue 4 (Feb 14 2022) ISSN: 2072-6643 [Electronic] Switzerland
• PMID: 35215445 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)

Chemical References

• Gastrointestinal Agents
• Peptides
• teduglutide

Topics

• Adult
• Gastrointestinal Agents (therapeutic use)
• Humans
• Parenteral Nutrition
• Peptides (therapeutic use)
• Short Bowel Syndrome (drug therapy)