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?1

This prospective observational study evaluated the role of teduglutide, a semisynthetic analogue of glucagon-like peptide-2 (sGLP-2), in reducing the need for parenteral nutrition in adults with short bowel syndrome. One hundred eight patients underwent autologous gastrointestinal reconstruction surgery (AGIRS), and 74 (68.5%) achieved intestinal sufficiency (parenteral nutrition (PN) not restarted by 6 months after its suspension) with standard medical therapy.

Patients unable to continue decreasing PN volume for 6 months were evaluated (with colonoscopy and laboratory investigations) to start sGLP-2. Seventeen patients were started on sGLP-2. The most common underlying aetiology (42.8%) was intestinal ischaemia. Some patients could not start treatment due to active malignancies, preneoplasm, inflammatory bowel disease or lack of insurance.

The mean volume of PN at the beginning of sGLP-2 treatment was 12.1±3.9 L/week. Twelve of 17 patients started sGLP-2 between 2014 and 2018, of whom 8 discontinued PN in a mean time of 25.8 weeks. One restarted PN due to renal lithiasis and renal impairment. Seven remained independent of PN at the time of publication. Of these, three patients had postoperative intestinal length (ligament of Treitz to ileocaecal valve or colonic anastomosis) of less than 50 cm and four had postoperative intestinal length of 51–99 cm. All patients who weaned PN had partial or total …