Efficacy of Teduglutide for Pediatric and Short Bowel Syndrome-Associated Intestinal Failure: A Systematic Review

Abstract

Background: Intestinal failure secondary to short bowel syndrome (SBS) is a severe malabsorptive condition often requiring long-term parenteral nutrition (PN). Teduglutide, a glucagon-like peptide-2 (GLP-2) analogue, promotes intestinal adaptation and may reduce PN dependence. This systematic review evaluated the efficacy of teduglutide in reducing PN requirements in pediatric patients with intestinal failure.

Methods: Clinical studies evaluating teduglutide therapy in pediatric patients with intestinal failure secondary to SBS were included. Randomized trials, non-randomized studies, and post-hoc analysis of clinical trials were considered due to the limited number of pediatric studies available. Risk of bias was assessed using the RoB-2 (Cochrane) tool, and statistical analyses were performed using Review Manager 5.4.1.

Results: Teduglutide therapy was associated with a significantly higher likelihood of achieving a clinically meaningful ≥ 20% reduction in PN volume compared with standard of care (odds ratio 11.79; 95% confidence interval, 2.04–68.24; P = 0.006). Treatment was also associated with improvement in length/height-for-age z-score, while no significant difference was observed in weight-for-length z-score.

Conclusion: Findings support teduglutide as an effective therapeutic option to reduce PN dependence and promote progression toward enteral nutrition autonomy in pediatric patients with SBS-associated intestinal failure.