TEDUGLUTIDE USE IN ENGLAND OUTSIDE CLINICAL TRIALS - SINGLE CENTRE EXPERIENCE.

Cernat, E.; Steele J.; Harvey O.; Iglesias N.; Goldthorpe J.; Brogan H.; Gomez Lopez L.

TEDUGLUTIDE USE IN ENGLAND OUTSIDE CLINICAL TRIALS - SINGLE CENTRE EXPERIENCE.

All Authors

Cernat, E.

Steele J.

Harvey O.

Iglesias N.

Goldthorpe J.

Brogan H.

Gomez Lopez L.

LTHT Author

Cernat, Elena
Steele, Julie
Harvey, Olivia
Iglesias, Natalia
Goldthorpe, Jenny
Brogan, Helen
Gomez-Lopez, Lilianne

LTHT Department

Leeds Children's Hospital
Abdominal Medicine & Surgery
Children's Dietetic Team

Non Medic

Dietitian
Nutrition Clinical Nurse Specialist
Pharmacist
Nurse Specialist
Nurse Specialist

Publication Date

2024

Item Type

Conference Abstract

Abstract

Teduglutide is a synthetic analogue of the glucagon-like peptide type 2 used to promote intestinal adaptation in patients with short bowel syndrome (SBS) dependent on parenteral nutrition (PN). Although used in paediatric clinical trials for the last 10 years,1 2 the treatment was approved by NICE in England, Wales and Northern Ireland in June 2022. The objective of our study was to describe our experience in using Teduglutide in two patients. The dose of Teduglutide used was 0.05mg/kg given as a daily subcutaneous injection. Patient 1: 12 years old boy, SBS secondary to complex gastroschisis - initial anatomy 10 cm small bowel, after several lengthening procedures, 85 cm. D-lactic acidosis, last episode in 2019. PN 7 nights a week over 14 hours (5 fat free nights), tolerating a normal diet. Patient started Teduglutide in February 2023. After 39 weeks 2 days on Teduglutide, PN was stopped (see table 1). The bloods have been stable during this period. Loperamide was stopped after 3 weeks of treatment. There was also an improvement in body mass composition - Body fat 19.5%, Muscle mass 76.1% before treatment compared with Body fat 16.4% and Muscle mass 79.1% when PN stopped. PN stopped 8/11/23. Patient 2: 18 years old girl with SBS secondary to neonatal volvulus - remaining anatomy 10 cm small bowel. D-lactic acidosis with multiple admissions since 2016. PN 4 nights/ week, over 12 hours. Patient started Teduglutide in July 2023. After 7 weeks on treatment, PN was stopped (see table 2). Loperamide stopped after 3 weeks. Patient off PN for the last 13 weeks, continued to have ongoing episodes of D-lactic acidosis and hypomagnesemia for which she was started on Magnesium infusions twice weekly. She has been transitioned in September. In conclusion, Teduglutide appears safe and effective in reducing PN requirements in paediatric patients but more data is needed to understand it's long term efficacy and results after discontinuation.3. (Table Presented).