A113 TEDUGLUTIDE IN PATIENTS WITH ACTIVE CROHN’S DISEASE AND SHORT BOWEL SYNDROME
Bibliographic record
Abstract
Patients with Crohn’s disease (CD) are at risk of surgery due to refractory or penetrating disease, which may result in short bowel syndrome (SBS) that requires parenteral nutrition (PN). Teduglutide is a GLP2 analogue that has been approved for the treatment of SBS although there has been limited evidence for its use in CD patients. There is a theoretical risk of exacerbating mucosal inflammation with teduglutide due to intestinotrophic effects of GLP2. To assess the safety and efficacy of combined biologic therapy and teduglutide in patients with active CD and SBS. We present two cases of CD patients with active inflammation and SBS treated with combination biologic therapy and teduglutide. The first case is a 38-year-old male with ileocolic stricturing CD, who previously failed methotrexate, azathioprine, infliximab and adalimumab. He underwent multiple small bowel and ileocolic resections resulting in SBS and was initiated on 7-day home parenteral nutrition (PN) in 2011 for SBS. Teduglutide was commenced in January 2017 and he was able to wean completely off PN within seven months. Ileocolic anastomotic inflammation was treated with ustekinumab in July 2017, and both treatments have been maintained for 14 months without any adverse events. The second case is a 39-year-old male with stricturing small bowel CD, who previously methotrexate, azathioprine failed infliximab, adalimumab, , and was steroid-dependent. After multiple small bowel resections, he was left with a jejunocolic anastomosis with approximately 60 cm of residual small bowel length. Daily PN was initiated in 2003. He was initiated on vedolizumab and 6-mercaptopurine in 2016 due to pancolonic ulcerations. Teduglutide was added in August 2017 with significant clinical improvement in his oral intake, reduced stool output, and 4kg weight gain, with reduction in PN requirements to one night/week within 12 months of teduglutide. These two cases suggest that teduglutide may be safe, effective and can be used with concomitant biologic agents and immunosuppressants in patients with active CD and SBS. However, longer term follow-up and more reports are needed to evaluate the safety of teduglutide in this setting. None
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".