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
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".