Postsurgical Intestinal Rehabilitation Using Semisynthetic Glucagon-Like Peptide-2 Analogue (sGLP-2) at a Referral Center: Can Patients Achieve Parenteral Nutrition and sGLP-2 Independency?

Autor: Solar H; Intestinal Failure, Rehabilitation and Transplant Unit, Favaloro Foundation, University Hospital, Buenos Aires, Argentina.; Translational Medicine, Transplantation and Bioengineering Research Institute (IMeTTyB), Favaloro University, Buenos Aires, Argentina., Doeyo M; Intestinal Failure, Rehabilitation and Transplant Unit, Favaloro Foundation, University Hospital, Buenos Aires, Argentina.; Translational Medicine, Transplantation and Bioengineering Research Institute (IMeTTyB), Favaloro University, Buenos Aires, Argentina., Ortega M; Intestinal Failure, Rehabilitation and Transplant Unit, Favaloro Foundation, University Hospital, Buenos Aires, Argentina.; Translational Medicine, Transplantation and Bioengineering Research Institute (IMeTTyB), Favaloro University, Buenos Aires, Argentina., De Barrio S; Nutritional Support and Malabsorptive Disorders Unit, San Martin Hospital, La Plata, Argentina., Olano E; Special Nutrition Unit, Maciel Hospital, Montevideo, Uruguay., Moreira E; Special Nutrition Unit, Maciel Hospital, Montevideo, Uruguay., Buncuga M; Nutritional Support Unit, Delta Hospital, Rosario, Argentina., Manzur A; Organ and Tissue Transplant Department, Central Hospital, Mendoza, Argentina., Crivelli A; Intestinal Failure, Rehabilitation and Transplant Unit, Favaloro Foundation, University Hospital, Buenos Aires, Argentina.; Translational Medicine, Transplantation and Bioengineering Research Institute (IMeTTyB), Favaloro University, Buenos Aires, Argentina., Gondolesi G; Intestinal Failure, Rehabilitation and Transplant Unit, Favaloro Foundation, University Hospital, Buenos Aires, Argentina.; Translational Medicine, Transplantation and Bioengineering Research Institute (IMeTTyB), Favaloro University, Buenos Aires, Argentina.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2021 Jul; Vol. 45 (5), pp. 1072-1082. Date of Electronic Publication: 2020 Aug 25.
DOI: 10.1002/jpen.1983
Abstrakt: Background: Teduglutide, a semisynthetic analogue of glucagon-like peptide-2 (sGLP-2), increases intestinal absorption of fluids and nutrients, reducing the need for parenteral nutrition (PN). This report aims to describe our experience with sGLP-2 in a cohort of adult patients with short-bowel syndrome.
Methods: This is a prospective observational study on adult patients initially evaluated in our specialized intestinal rehabilitation program that received sGLP-2 from June 2014 to March 2020.
Results: Autologous gastrointestinal reconstruction surgery (AGIRS) was performed in 108 patients; 68.5% (74 of 108) achieved intestinal sufficiency with standard medical therapy. Seventeen patients were treated with sGLP-2; 66.5% (8 of 12) received treatment for a mean time of 25.8 weeks (3.4-54.0) and could suspend PN. One patient reinitiated treatment due to renal lithiasis and acute renal failure. Currently, 7 of 12 patients (53.8%) continue without PN for a mean time of 165.6 weeks. Volume, energy, and days of PN were reduced in all patients. No serious adverse events were registered. Four of 7 patients (57.1%) who discontinued PN could also discontinue sGLP-2. Therefore, the use of sGLP-2 increased the overall success rate of PN independency after AGIRS to 76% (82 of 108).
Conclusion: This study confirmed that sGLP-2 should be considered as part of the standard therapy for postsurgical medical rehabilitation treatment in patients with chronic intestinal failure. We add to the current knowledge that some patients can discontinue both PN and sGLP-2 in the long term, achieving complete recovery of their quality of life.
(© 2020 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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