| Autor: |
de Dreuille B; Department of Gastroenterology and Nutrition Support, Hôpital Beaujon (AP-HP), 92110 Clichy, France.; Inserm UMR 1149, Centre de Recherche sur l'Inflammation, Université Paris Cité, 75018 Paris, France., Nuzzo A; Department of Gastroenterology and Nutrition Support, Hôpital Beaujon (AP-HP), 92110 Clichy, France.; Inserm UMR 1148, Laboratoire de Recherche Vasculaire Translationnelle, Université Paris Cité, 75018 Paris, France., Bataille J; Pharmacy Department, Hôpital Beaujon (AP-HP), 92110 Clichy, France., Mailhat C; GETAID (Groupe d'Étude Thérapeutique des Affections Inflammatoires du Tube Digestif), 75009 Paris, France., Billiauws L; Department of Gastroenterology and Nutrition Support, Hôpital Beaujon (AP-HP), 92110 Clichy, France.; Inserm UMR 1149, Centre de Recherche sur l'Inflammation, Université Paris Cité, 75018 Paris, France., Le Gall M; Inserm UMR 1149, Centre de Recherche sur l'Inflammation, Université Paris Cité, 75018 Paris, France., Joly F; Department of Gastroenterology and Nutrition Support, Hôpital Beaujon (AP-HP), 92110 Clichy, France.; Inserm UMR 1149, Centre de Recherche sur l'Inflammation, Université Paris Cité, 75018 Paris, France. |
| Abstrakt: |
Teduglutide, a GLP-2 analogue, has been available in France since 2015 to treat short-bowel-syndrome (SBS)-associated chronic intestinal failure (CIF) but it remains very expensive. No real-life data on the number of potential candidates are available. The aim of this real-life study was to assess teduglutide initiation and outcomes in SBS-CIF patients. All SBS-CIF patients cared for in an expert home parenteral support (PS) center between 2015 and 2020 were retrospectively included. Patients were divided into two subpopulations: prevalent patients, already cared for in the center before 2015, and incident patients, whose follow-up started between 2015 and 2020. A total of 331 SBS-CIF patients were included in the study (156 prevalent and 175 incident patients). Teduglutide was initiated in 56 patients (16.9% of the cohort); in 27.9% of prevalent patients and in 8.0% of incident patients, with a mean annual rate of 4.3% and 2.5%, respectively. Teduglutide allowed a reduction in the PS volume by 60% (IQR: 40-100), with a significantly higher reduction in incident versus prevalent patients ( p = 0.02). The two- and five-year treatment retention rates were 82% and 64%. Among untreated patients, 50 (18.2%) were considered ineligible for teduglutide for non-medical reasons. More than 25% of prevalent SBS patients were treated with teduglutide compared to 8% of incident patients. The treatment retention rate was >80% at 2 years, which could be explained by a careful selection of patients. Furthermore, this real-life study confirmed the long-term efficacy of teduglutide and showed a better response to teduglutide in incident patients, suggesting a benefit in early treatment. |
