Three-year experience with GLP-2 analog in intestinal rehabilitation for pediatric-onset short bowel syndrome

Area of Science:

• Gastroenterology
• Pediatric Gastroenterology
• Clinical Pharmacology

Background:

• Short bowel syndrome (SBS) is a complex condition often requiring long-term parenteral nutrition (PN).
• Intestinal rehabilitation is crucial for managing SBS and reducing PN dependency.
• Glucagon-like peptide 2 (GLP-2) analogs represent a therapeutic option to enhance intestinal adaptation.

Purpose of the Study:

• To assess the three-year impact of Glucagon-like peptide 2 (GLP-2) analog therapy on parenteral nutrition (PN) dependency.
• To evaluate the effects of GLP-2 analog therapy on intestinal rehabilitation and quality of life in pediatric-onset short bowel syndrome (SBS).

Main Methods:

• Retrospective analysis of clinical data from 18 pediatric-onset SBS patients undergoing GLP-2-based intestinal rehabilitation over three years.
• Evaluation of changes in PN requirements, serum citrulline levels, stool parameters, and quality of life indicators.
• Monitoring for adverse events and intestinal polyps.

Main Results:

• Significant reductions in PN requirements were observed, with up to 54.6% decrease in adults and 31.9% in pediatric patients.
• Improvements in serum citrulline levels indicated enhanced intestinal adaptation; stool consistency and frequency also improved.
• One adult and one pediatric patient achieved PN independence, and overall quality of life was maintained, though some pediatric patients required educational support due to ongoing PN use.

Conclusions:

• GLP-2 analog therapy, integrated with intestinal rehabilitation, leads to sustained reductions in PN dependency and improved clinical outcomes in SBS patients over three years.
• Continuous GLP-2 analog therapy shows promise for enhancing the quality of life in pediatric-onset SBS.
• The therapy was well-tolerated, with mild and self-limiting adverse events and no detected intestinal polyps.