Teduglutide was accepted for use in Scotland for the treatment of SBS, in children in 2018 and extended to adults in January 2020 (1).
Short bowel syndrome is described as intestinal malabsorption, which is associated with a functional small intestine length of less than 200 cm (2). Clinical management of SBS currently aims to maximize available intestinal function by managing oral fluids, dietary modification and the use of anti-secretory / anti-motility medications. Supplementary fluids, macro and micro nutrients are given as required to maintain health via Parenteral Supplementation (PS) (3).
The intestinal mucosa lining the intestine ensures that the body is protected from undesirable bowel content while ensuring the absorption of nutrients. Maintenance, growth and repair of the intestinal mucosa are dependent on many factors. Peptide hormones, including glucagon like peptide-2 (GLP2), can reduce secretions and gastric motility as well as stimulate mucosal growth (3).
Teduglutide is a GLP2 analogue which has been shown in trials to promote and repair the mucosal layer of the intestine by increasing the height of villus and depth of crypts (1).
It is given once daily following reconstitution as a subcutaneous injection of 0.05mg/kg.
NHSGGC Formulary highlights that Teduglutide is restricted for prescribing to the IFT for patients with SBS after all other treatments have been optimized. Patients must be stable on PS for at least 2 years and success of Teduglutide is measured in the reduction of PS. (4)