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Maintenance of Parenteral Nutrition Volume Reduction, Without Weight Loss, After Stopping Teduglutide in a Subset of Patients With Short Bowel Syndrome
Author(s) -
Compher Charlene,
Gilroy Richard,
Pertkiewicz Marek,
Ziegler Thomas R.,
Ratcliffe Sarah J.,
Joly Francisca,
Rochling Fedja,
Messing Bernard
Publication year - 2011
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607111414431
Subject(s) - medicine , parenteral nutrition , context (archaeology) , body mass index , gastroenterology , weight loss , short bowel syndrome , clinical trial , drug , surgery , obesity , pharmacology , paleontology , biology
Background : Teduglutide was discontinued after being tested for ≥ 24 weeks in patients with parenteral nutrition (PN) ‐dependent short bowel syndrome in a clinical trial for efficacy to reduce PN volume. This study was describes change in body mass index (BMI) and PN volume over 12 months in patients who stopped drug after the clinical trial. Methods : Prescribed PN volume, weight, and complications were reported. Patients with stable (NEUT, n = 15) or decreased (DEC, n = 7) PN volume by 12 months after stopping drug (NEUT/DEC, n = 22) were compared to those who had increased PN volume (INC, n = 15). With drug response defined by ≥20% reduction from pre‐drug PN volume to end of drug therapy, 12 INC and 13 NEUT/DEC patients were drug responders. Results : Eleven of 20 eligible sites reported data for 39 of 53 eligible study participants, with follow‐up data for 37. INC patients had shorter colon and less frequently had colon in continuity than NEUT/DEC. BMI was decreased at 3, 6, and 12 months relative to the first off‐drug visit in INC patients (P = .001), but not in NEUT/DEC patients. Change in BMI off‐drug was predicted by colon and small bowel length, baseline BMI, and on‐drug change in PN volume (adjusted R2 = 0.708). Conclusions : Gastrointestinal anatomy, baseline BMI, and PN volume reduction on‐drug predicted change in BMI off‐drug. Whether this response would be maintained for a longer time or in the context of a challenging clinical situation has not been evaluated.