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: | Adriana Crivelli, Martin Buncuga, Silvia De Barrio, Mariana Doeyo, Eduardo Moreira, Alejandra Manzur, Estela Olano, Hector Solar, Gabriel E. Gondolesi, Mariana Ortega |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Short Bowel Syndrome medicine.medical_specialty Parenteral Nutrition 030309 nutrition & dietetics Medicine (miscellaneous) Teduglutide Intestinal absorption 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Quality of life Gastrointestinal Agents Glucagon-Like Peptide 2 Medicine Humans Adverse effect Referral and Consultation 0303 health sciences Nutrition and Dietetics business.industry Short bowel syndrome medicine.disease Chronic intestinal failure Surgery Parenteral nutrition chemistry Cohort Quality of Life 030211 gastroenterology & hepatology business |
| Zdroj: | JPEN. Journal of parenteral and enteral nutritionReferences. 45(5) |
| ISSN: | 1941-2444 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text