Real-world experience of teduglutide for the treatment of short bowel syndrome-associated intestinal failure

BACKGROUND & AIMS: Patients with short bowel syndrome-associated intestinal failure (SBS-IF) require parenteral nutrition and/or intravenous fluids (PN/IV); however, long-term dependence can lead to complications. Teduglutide enhances mucosal growth and the absorptive function of the residual intestine and reduces dependence on PN/IV. We aimed to investigate the use of teduglutide in real-world settings. METHODS: This retrospective study assessed outcomes in adult patients with SBS-IF who had received teduglutide (ever-treated cohort) or were eligible for teduglutide but had never received it (never-treated cohort). De-identified medical record data between December 21, 2011 and March 1, 2023 were abstracted from patient charts at US-based centers. Outcomes were analyzed using descriptive statistics and Kaplan-Meier methods. RESULTS: Age, presence of a stoma, time since SBS-IF diagnosis, and PN/IV frequency significantly differed between the ever-treated (n = 103) and never-treated cohorts (n = 121) at baseline. During follow-up, ever-treated (mean duration, 19.4 months) and never-treated patients (mean duration, 19.1 months) had similar reductions from baseline in PN/IV days per week (mean [standard deviation] change: -0.9 [2.1] vs -1.0 [2.8] days) and PN/IV volume (-1.7 [3.6] vs -2.0 [6.2] L/week). Mean (SD) change in PN/IV energy received during follow-up was -1110.4 [3158.2] kcal/week for ever-treated patients and -408.3 [2836.2] kcal/week for never-treated patients. Clinical response and enteral autonomy were attained by 62.9 % and 20.2 % of ever-treated patients and 55.9 % and 27.9 % of never-treated patients, respectively. In ever-treated patients, 71.8 % experienced a treatment delay, 35.0 % discontinued teduglutide treatment, and 16.5 % experienced a treatment interruption. CONCLUSION: In this real-world US multicenter chart review study, PN/IV dependency reduced in patients with SBS-IF receiving or not receiving teduglutide. Heterogeneity in patient characteristics and treatment delays, discontinuations, and interruptions may have impacted the effectiveness of teduglutide. These results will inform healthcare professionals of the current practices and typical outcomes associated with teduglutide treatment.