Citrulline correlations in short bowel syndrome–intestinal failure by patient stratification: Analysis of 24 weeks of teduglutide treatment from a randomized controlled study
Autor: | Simon M. Gabe, Palle Jeppesen, Clément Olivier, Douglas L. Seidner, Hak-Myung Lee |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male Short Bowel Syndrome 0301 basic medicine Parenteral Nutrition medicine.medical_specialty Colon Population 030209 endocrinology & metabolism Critical Care and Intensive Care Medicine Teduglutide Gastroenterology law.invention Stoma 03 medical and health sciences chemistry.chemical_compound Postoperative Complications 0302 clinical medicine Gastrointestinal Agents Randomized controlled trial law Internal medicine Intestine Small Post-hoc analysis medicine Citrulline Humans education Colectomy education.field_of_study 030109 nutrition & dietetics Nutrition and Dietetics Vascular disease business.industry Middle Aged Short bowel syndrome medicine.disease Treatment Outcome chemistry Linear Models Female Drug Monitoring Peptides business |
Zdroj: | Jeppesen, P B, Gabe, S M, Seidner, D L, Lee, H-M & Olivier, C 2020, ' Citrulline correlations in short bowel syndrome-intestinal failure by patient stratification : Analysis of 24 weeks of teduglutide treatment from a randomized controlled study ', Clinical Nutrition, vol. 39, no. 8, pp. 2479-2486 . https://doi.org/10.1016/j.clnu.2019.11.001 |
ISSN: | 0261-5614 0079-8967 |
Popis: | BACKGROUND & AIMS: Disease-associated factors influence parenteral support (PS) reduction in response to teduglutide in patients with intestinal failure associated-short bowel syndrome (SBS-IF). We sought to determine correlative relationships between plasma citrulline levels, small bowel length, and PS volume.METHODS: A post hoc analysis of plasma citrulline levels from patients in the STEPS 24-week study of teduglutide in patients with SBS-IF. Plasma citrulline was assessed in all patients; patients were stratified 3 times into subgroups based on bowel anatomy, cause of SBS-IF, and baseline PS volumes. Correlation analyses used simple linear regression models. Statistical comparisons between study groups were conducted using 2-sided t tests for 2 independent mean differences.RESULTS: Baseline plasma citrulline correlated with remnant small bowel length (r = 0.355, P = 0.002), but not with baseline PS volume (r = -0.167, P = 0.14), in the overall population. There was a robust correlation between the baseline and Week 24 citrulline (r = 0.705, P < 0.0001), and an inverse correlation between change from baseline in citrulline and PS volume from baseline to Week 24 (r = -0.359, P = 0.001). In all subgroups, patients treated with teduglutide showed numerically greater increases in plasma citrulline at Week 24 compared with placebo.CONCLUSION: Baseline plasma citrulline showed significant correlations with small bowel length in patients with ≥50% colon remaining/no stoma/colon-in-continuity, and patients with SBS-IF causes other than IBD/vascular disease. Citrulline levels may correlate with PS changes in response to teduglutide and more research may reveal a relationship between citrulline levels within the heterogeneous population of patients with SBS-IF. ClinicalTrials.gov NCT00798967, ClinicalTrialsRegister.eu 2008-006193-15. |
Databáze: | OpenAIRE |
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