Clinical outcomes of teduglutide therapy in children with short bowel syndrome-associated intestinal failure: A single-center experience.

Background: Short bowel syndrome-associated intestinal failure (SBS-IF) requires long-term parenteral nutrition (PN), increasing the risk of complications such as central line associated bloodstream infections, sepsis and liver disease. Teduglutide, a glucagon-like peptide-2 (GLP-2) analog, has been shown to enhance intestinal adaptation and reduce PN dependence, but long-term real-world data in children are limited. Objectives: To describe the medium-term clinical outcomes and safety profile of teduglutide treatment in children with short bowel syndrome-associated intestinal failure (SBS-IF). Methods: A retrospective cohort study was conducted at a single tertiary center. There were 41 children with SBS-IF treated with Teduglutide among the 161children who were managed at the center between 2018 and 2022. Data on PN requirements, growth parameters, and treatment duration were analyzed. The time to PN weaning was assessed using a Cox proportional hazards model. Results: At a median follow-up of 29.2 months, 21 patients (51.2%) were successfully weaned off PN, and 24 patients (65%) achieved at least a 20% reduction in PN requirements. The median time to complete PN weaning was 7.3 months. Baseline variables associated with time to PN discontinuation included the percentage of PN-derived calories at treatment initiation and residual small bowel length. No treatment-related adverse events were reported, although 12% of patients required increased PN support over time. Conclusions: Teduglutide reduced PN dependence in children with SBS-IF, with over half achieving enteral autonomy. These findings support its role in intestinal rehabilitation and emphasize the need for individualized treatment strategies based on baseline clinical characteristics associated with response.