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Treating short bowel syndrome with pharmacotherapy
Mariana Hollanda Martins Da Rocha1,2, André Dong Won Lee1,3, Marcia Lucia De Mario Marin1,4
1Clinical nutrition multidisciplinary team (MDT), Hospital das Clinicas , Sao Paulo, Brazil.
Expert Opinion on Pharmacotherapy
|February 15, 2020
Summary
Short bowel syndrome (SBS) is now a manageable condition thanks to new treatments. Glucagon-like peptide-2 (GLP-2) analogs show promise for improving absorption and could become a future standard of care.
Area of Science:
- Gastroenterology
- Pharmacology
- Internal Medicine
Background:
- Short bowel syndrome (SBS) was historically a fatal condition.
- Advances in home parenteral nutrition have transformed SBS into a chronic illness.
- New pharmacological treatments target the underlying pathophysiology of SBS.
Purpose of the Study:
- To review current and emerging treatments for short bowel syndrome.
- To evaluate the efficacy of antidiarrheal drugs and GLP-2 analogs.
- To discuss surgical options for SBS.
Main Methods:
- Review of home parenteral nutrition's impact on SBS mortality.
- Assessment of off-label antidiarrheal drug use.
- Evaluation of glucagon-like peptide-2 (GLP-2) analogs for malabsorption.
- Discussion of surgical interventions like intestinal lengthening and transplantation.
Main Results:
- Home parenteral nutrition has significantly reduced SBS mortality since the 1970s.
- Antidiarrheal drugs are standard care but lack strong efficacy evidence.
- GLP-2 analogs demonstrate significant promise for alleviating malabsorption in adults with massive intestinal losses.
Conclusions:
- GLP-2 analogs represent a novel class of disease-modifying, absorption-restoring agents for SBS.
- These agents have the potential to become a therapeutic benchmark for severe intestinal loss.
- Future applications may extend to all contexts of significant intestinal failure.
Keywords:
GLP-2GLP-2 analogsGlepaglutideHome parenteral nutritionIntestinal insufficiencyMassive bowel resectionShort bowel syndromeTeduglutideMore Related Videos
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