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Growth factors and their use in short bowel
Siddhartha Oke1, Merlin N M Walter, Tahera Ansari
1aSt. Mark's Hospital, Harrow bDepartment of Surgery and Cancer, Imperial College, London cNorthwick Park Institute for Medical Research, Harrow, Middlesex, United Kingdom.
Purpose Of Review:
To examine the most recent literature on the clinical trials associated with the relevant growth factors that have been of interest in the treatment of short bowel.
Recent Findings:
Short bowel is a rare but devastating condition that condemns patients to lifelong parenteral support. Historically, treatment options negating the need for parenteral support were limited. Therapeutic growth factor use is of interest, but the clinical trial data are inconclusive. The STEPS-2 trial was the first trial that showed a sustained positive effect of the growth factor glucagon-like peptide-2 (GLP-2). This led to a phase shift in the management of short bowel, with the US Food and Drug Administration approval of the GLP-2 analogue teduglutide in 2012. This review summarizes all the relevant clinical trials of growth factors in the treatment of short bowel.
Summary:
GLP-2 has shown that growth factors can revolutionize the treatment of short bowel. Data however are lacking with regards to the solitary use of other factors. This review highlights the need for further work using the factors in combination as well as considering their use in novel methods for example in the field of regenerative medicine.
Insights
Growth factors, particularly glucagon-like peptide-2 (GLP-2), show promise in revolutionizing short bowel syndrome treatment. Clinical trials indicate GLP-2 analogues like teduglutide offer sustained benefits, reducing reliance on parenteral support.
Area of Science:
- Gastroenterology
- Regenerative Medicine
- Clinical Trials
Background:
- Short bowel syndrome (SBS) is a rare, severe condition requiring lifelong parenteral support.
- Limited historical treatment options exist for SBS.
- Therapeutic growth factors are being investigated for SBS management.
Purpose of the Study:
- To review recent literature on clinical trials of growth factors for short bowel syndrome treatment.
- To assess the efficacy of various growth factors in managing SBS.
Main Methods:
- Systematic review of clinical trials involving growth factors in SBS.
- Analysis of data from trials, including the STEPS-2 trial.
Main Results:
- Glucagon-like peptide-2 (GLP-2) demonstrated sustained positive effects in the STEPS-2 trial.
- GLP-2 analogue teduglutide received FDA approval in 2012, marking a shift in SBS management.
- Clinical trial data for other growth factors remain inconclusive.
Conclusions:
- Glucagon-like peptide-2 (GLP-2) has significantly advanced short bowel syndrome treatment.
- Further research is needed on the combined use of growth factors and novel applications like regenerative medicine.
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