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Clin Nutr ; 40(6): 4065-4074, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33637328

RESUMO

BACKGROUND AND AIMS: The glucagon-like peptide-2 (GLP-2) analogue, teduglutide, allows to reduce the intravenous supplementation (IVS) dependency of patients with short bowel syndrome and intestinal failure (SBS-IF). The rate of candidacy of SBS-IF patients for the treatment is unknown. The candidacy for teduglutide treatment of our patient cohort was investigated by a systematic analysis. METHODS: The indications, contraindications, special warnings and precautions for use of teduglutide, listed in the drug monographs and in the phase-III trial protocol were adopted to categorize the patients as non-candidates (NC), potential candidates (PC) or straight candidates (SC) for the treatment. All the SBS-IF adult patients who were cured at our centre were assessed according to their clinical status on January 1st, 2020. RESULTS: Seventy-nine patients were evaluated: 34.2% were NC due to risk of digestive malignancy, recent history of any other cancer, or listing for intestinal transplantation; 30.4% were PC, because of other premalignant conditions, risk of intestinal obstruction, entero-cutaneous fistulas, or severe co-morbidities; 35.4% were SC. The SC group showed the lowest requirement of IVS: the lowest number of days of infusion per week (p = 0.0054), the lowest amount of energy (p = 0.0110) and volume (p = 0.0136). CONCLUSIONS: This systematic analysis allowed a pragmatic categorization of the candidacy of patients with SBS-IF for GLP-2 analogue treatment. The SC group appeared to have the highest probability of a successful response to the treatment. A systematic analysis of SBS-IF patient candidate for GLP-2 analogue therapy would allow a homogeneous patient selection and facilitate the worldwide comparison of the results of clinical practice and research.


Assuntos
Fármacos Gastrointestinais/uso terapêutico , Insuficiência Intestinal/tratamento farmacológico , Seleção de Pacientes , Peptídeos/uso terapêutico , Síndrome do Intestino Curto/tratamento farmacológico , Idoso , Ensaios Clínicos Fase III como Assunto , Estudos Transversais , Feminino , Humanos , Insuficiência Intestinal/sangue , Insuficiência Intestinal/etiologia , Itália , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Síndrome do Intestino Curto/sangue , Síndrome do Intestino Curto/complicações
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