Teduglutide

Teduglutide is a recombinant analogue of human glucagon-like peptide-2 (GLP-2) used to treat short bowel syndrome (SBS) in adults who are dependent on parenteral nutrition. It is marketed under the brand names Gattex in the United States and Revestive in several other regions. The medicine is given as a subcutaneous injection once daily, with the dose tailored to the patient’s body weight and clinical response.

As a GLP-2 analogue, teduglutide acts on intestinal mucosa to promote growth and regeneration of the intestinal lining. It increases mucosal surface area by expanding villus height and crypt depth, which can enhance the absorptive capacity of the remaining intestine. By improving absorption, teduglutide aims to reduce the volume of parenteral nutrition required to meet nutritional needs in SBS patients.

Indications and usage are centered on adults with SBS who require ongoing parenteral nutrition. The goal of therapy is to decrease dependence on PN and improve nutritional status. Regulatory approvals and labeling may vary by country, and clinicians consider individual patient factors when determining suitability.

Safety and adverse effects require careful monitoring. Common side effects can include abdominal pain, nausea, injection-site reactions, and headaches. More serious concerns include the potential risk of neoplasia or progression of gastrointestinal lesions due to mucosal stimulation, as well as signs of gastrointestinal obstruction. Patients with a history of GI cancer or active GI tumors require careful evaluation before therapy. Regular follow-up with healthcare providers is essential to assess benefits and risks.