S1351 Clinical Outcomes of Adult Patients With Short Bowel Syndrome Treated With Teduglutide: A 2-year Cohort Study From the Canadian Home Parenteral Nutrition Registry
Notice bibliographique
Résumé
Introduction: Clinical trials have shown that teduglutide, a synthetic GLP-2 analog, reduces the need for parenteral support (PS) in adult patients with short bowel syndrome (SBS). The objective of this study was to assess, in routine clinical practice, the outcomes of SBS patients on PS enrolled in the Canadian home parenteral nutrition (HPN) registry. Methods: This is a retrospective analysis of prospectively collected data extracted from the password protected, internet-based Canadian HPN registry. Adult SBS patients from 9 HPN programs, treated with teduglutide between January 2015 and 2021, were included. Data was collected every 6 months for 2 years and included demographics, anthropometrics, PS prescriptions, laboratories, hospitalizations, and quality of life based on the Karnofsky Performance Status (KPS). Response was defined as a daily PS volume reduction of ≥ 20% from baseline. Data was compared using Wilcoxon Rank Sum tests for continuous variables and Fisher’s exact tests for categorical variables. Results: 32 patients [(19 (59%) women; age 57.6 ± 12.8 years)] were included, representing about 50% of patients receiving teduglutide in Canada. The main cause of SBS was Crohn’s disease (n = 15, 47%); length of remaining small bowel was 79.5 ± 58.6 cm, and 14 patients (44%) had a colon in continuity. Over the study duration, 69% (n = 23) were responders and 28% (n = 9) achieved PS independency. Response at 18 months was associated with a longer PS duration before starting teduglutide (P = 0.01), the absence of narcotics (P = 0.01), a high oral intake (P = 0.04), and Crohn’s disease (P = 0.01). Patients who had been weaned had a longer PS duration (P = 0.01), lower weekly infusion days at baseline (P = 0.02) and lack of narcotics (0.01). Creatinine and electrolyte levels remained within normal limits in all patients. Alkaline phosphatase (ALP) levels were significantly lower in weaned patients compared to non-weaned after 6 (P = 0.03) and 18 months (P = 0.01) of treatment. BMI, KPS and number of hospitalizations per year at baseline were comparable between responders and non-responders and remained comparable over the 2-year period. No severe adverse events were reported. Conclusion: Teduglutide was effective in reducing or weaning PS in SBS adult patients similarly to clinical trials. Overall, there were no changes in laboratory results except for an improvement in ALP in weaned subjects. Hospitalization rate, KPS and BMI did not change with PS reductions and teduglutide was well tolerated.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».