Unexpected upper gastrointestinal polyps in patients with short bowel syndrome treated with teduglutide: need for close monitoring.

Autor:	de Dreuille B; Gastroenterology and Nutritional Support Department, Hôpital Beaujon, Clichy, France; Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France., Cazals-Hatem D; Pathology Department, Hôpital Beaujon, Clichy, France., Ronot M; Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France; Radiology Department, Hôpital Beaujon, Clichy, France., Theou-Anton N; Biochemistry and Genetics, Hôpital Bichat, Paris, France., Dermine S; Gastroenterology and Nutritional Support Department, Hôpital Beaujon, Clichy, France., Le Beyec-Le Bihan J; Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France; Endocrine and Oncological Biochemistry Department, Hôpital Pitié-Salpêtrière, Paris, France., Billiauws L; Gastroenterology and Nutritional Support Department, Hôpital Beaujon, Clichy, France; Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France., Le Gall M; Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France., Bado A; Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France., Joly F; Gastroenterology and Nutritional Support Department, Hôpital Beaujon, Clichy, France; Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France. Electronic address: francisca.joly@aphp.fr.
Jazyk:	angličtina
Zdroj:	The American journal of clinical nutrition [Am J Clin Nutr] 2023 Jun; Vol. 117 (6), pp. 1143-1151. Date of Electronic Publication: 2023 May 03.
DOI:	10.1016/j.ajcnut.2023.02.015
Abstrakt:	Background: Teduglutide is a GLP-2 analog indicated for the treatment of short bowel syndrome (SBS) since 2015. Its efficacy in reducing parenteral nutrition (PN) has been shown in patients with SBS. Objectives: Because teduglutide is a trophic factor, the aim of this study was to assess risk of developing polypoid intestinal lesions during treatment. Methods: A retrospective study was conducted in 35 patients with SBS treated with teduglutide for ≥1 y in a home PN expert center. All patients underwent ≥1 follow-up intestinal endoscopy during treatment. Results: In the 35 patients, the small bowel length was 74 cm (IQR: 25-100), and 23 patients (66%) had a colon in continuity. Upper and lower gastrointestinal endoscopy was performed after a mean treatment duration of 23 mo (IQR: 13-27), and polypoid lesions were found in 10 patients (6 with a colon in continuity, 4 with an end jejunostomy) and no lesion in 25 patients. In 8 out of the 10 patients, the lesion was found in the small bowel. Five of these lesions presented an aspect of hyperplastic polyp without dysplasia, and 3 of a traditional adenoma with low-grade dysplasia. Conclusions: Our study highlights the importance of performing follow-up upper and lower gastrointestinal endoscopy in SBS patients treated with teduglutide and the potential need to make changes to the recommendations with respect to treatment initiation and follow-up. (Copyright © 2023. Published by Elsevier Inc.)
Databáze:	MEDLINE
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