PMID-35774551 – Teduglutide in Children With Intestinal Failure Systematic Review

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.

Related

#research #systematic-review #glp-2 #evidence-level-I