PMID-35774551 – Teduglutide in Children With Intestinal Failure Systematic Review
Gigola F, Cianci MC, Canazza L, Carraro A, Petreschi F, Silvestri E, Di Nardo G. Teduglutide in Children With Intestinal Failure Associated With Short Bowel Syndrome: A Systematic Review. Front Nutr. 2022;9:866518.
Quick Reference
| Property | Value |
|---|---|
| PMID | 35774551 |
| DOI | 10.3389/fnut.2022.866518 |
| Year | 2022 |
| Journal | Frontiers in Nutrition |
| Study Type | Systematic Review |
| Evidence Level | I |
| Sample | Pooled pediatric data from published trials and case series |
| Peptide(s) Studied | GLP-2 |
Key Findings
- Systematically reviewed all available evidence for teduglutide use in pediatric short bowel syndrome with intestinal failure (SBS-IF)
- Teduglutide at 0.05 mg/kg/day consistently reduced parenteral nutrition (PN) requirements in children across multiple studies
- Some children achieved enteral autonomy (complete PN independence) during treatment periods, a clinically transformative outcome
- Safety profile in children was consistent with the adult data: injection site reactions, abdominal pain, and GI symptoms were the most common adverse events
- The review identified significant heterogeneity in study designs, outcome measures, and patient populations across the pediatric literature
- Highlighted the need for long-term safety data, particularly regarding intestinal polyp surveillance and growth in developing children
Study Design
Systematic literature review following PRISMA guidelines. Searched PubMed, Embase, and Cochrane databases for studies of teduglutide in pediatric patients (age <18 years) with SBS-IF. Included clinical trials, observational studies, and case series. Assessed quality and synthesized efficacy and safety outcomes qualitatively.
Limitations
- Limited number of published pediatric studies available for inclusion, reflecting the rarity of pediatric SBS-IF
- Heterogeneous study designs precluded formal meta-analysis with pooled effect estimates
- Most included studies had small sample sizes and relatively short follow-up periods
- Publication bias cannot be excluded given the small number of studies and the involvement of the drug manufacturer in most trials
Clinical Relevance
This systematic review consolidates the evidence supporting teduglutide's use in pediatric SBS-IF, an area of high unmet medical need. It confirms that the intestinotrophic mechanism demonstrated in adults translates to children, and that enteral autonomy is achievable in select pediatric patients. Important for the GLP-2 peptide profile as it extends the evidence base beyond the adult population and informs clinical decision-making for pediatric gastroenterologists considering teduglutide therapy.
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#research #systematic-review #glp-2 #evidence-level-I