Introduction: Glucagon like Peptide-2 (GLP-2) is a protrophic gastrointestinal hormone that promotes regeneration of the intestinal mucosa and improves intestinal absorptive function. Teduglutide (TED), a GLP-2 analogue, was recently approved for the treatment of short bowel syndrome (SBS) patients with chronic intestinal failure (IF) who are dependent on parenteral support.

Methods: Center based clinical and paraclinical data of patients with benign SBS were analyzed retrospectively from patient's records. Clinical symptoms and infusion management were assessed after 3, 6, 12 and 24 months on TED.

Results: In total, 23 patients were treated with TED so far. In three patients (13%) TED was permanently discontinued and in 7 patients (30%) TED-dose was reduced to 50% of recommended dose.

For this interim analysis, records of 19 patients (mean age: 49 years; SD: 16y) with anatomical SBS type 1 (enterostomy; n=3), type 2 (jejunocolonic anastomosis; n=11), type 3 (ileocolonic anastomosis; n=1) or very short SBS (n=4) were analyzed. The median time between onset of PN-dependent IF and start of TED was 3 years (range 0,6 - 13,2 y). Primary causes for surgery resulting in SBS were mesenteric ischemia (n=8), IBD or complicated diverticulitis (n=5), trauma (n=3) or adhesion ileus (n=3).

Patients on TED had a significant reduction in stool frequency and more solid stool consistency (n=17; p=0.003 and p=0.002 resp.) after 6 months. While days of intravenous fluid (IVF) support remained constant (p=0,8) after 12 months on TED, patients gained a significant reduction in parenteral nutrition (PN) of 1.9 days/week (p=0,01) within that period. Three out of 20 patients (15%) who are currently on TED are weaned off PN after a mean treatment of 25 weeks (SD: 12 wks.), two continuing on IVF.

Conclusion: Clinical data of long-term use of TED in SBS patients with IF demonstrate clinical response likely due to increased net intestinal absorption of nutrients and fluids. Consequently, PN was reduced demonstrating a benefit with regard to infusion management and venous catheter access. Thus TED offers an improvement in clinical conditions and PN-management in SBS-patients suggesting improved intestinal rehabilitation.