Long-acting version of GLP-2, a hormone that makes the intestinal lining grow and work better. Used in short bowel syndrome to reduce the need for intravenous nutrition.
Regulatory status
Approved (FDA / EMA)
Family
Glucagon-like peptide 2 (GLP-2) analog
Scientific evidence
High
Number of findings
1
Where it acts
Digestion and weight
Also known as
teduglutide, Gattex, Revestive, ALX-0600
Regulatory status
FDA (US): Approved (2012, Gattex) for short bowel syndrome in adults and children aged 1 year or older who depend on parenteral support
EMA (EU): Approved (2012, Revestive) for short bowel syndrome in patients aged 1 year or older, stable after intestinal adaptation
Dose
0.05 mg/kg subcutaneously once a day (FDA/EMA label).
Safety
Abdominal pain and distension, nausea, injection-site reactions, and swelling. It may promote the growth of intestinal polyps and tumors: a colonoscopy is required before starting and periodically; contraindicated with active or recent gastrointestinal cancer. Risk of intestinal obstruction, gallbladder and pancreatic problems, and fluid overload. Only under the supervision of a nutrition or gastroenterology unit.
Interactions
By improving absorption, it may increase the effect of oral drugs with a narrow margin (for example, benzodiazepines or opioids); monitor and adjust.
Effect by goal · level of evidence
Reduced need for parenteral nutrition in short bowel
improvesHighRCT (AA)in people
63% vs 30% responders
STEPS trial with 86 patients over 24 weeks. 63% with teduglutide vs 30% with placebo reduced parenteral nutrition volume by at least 20%. Weekly volume fell by 4.4 L vs 2.3 L.
It activates the GLP-2 receptor in the intestine. This lengthens the villi, increases crypt depth, and improves absorption of fluids and nutrients. It also slows gastric emptying and acid secretion. A change in one amino acid makes it resistant to degradation and prolongs its effect.
What the evidence says
In people
Reduced need for parenteral nutrition in short bowel. STEPS trial with 86 patients over 24 weeks. A reduction of at least 20% in parenteral nutrition volume occurred in 63% with teduglutide versus 30% with placebo. Weekly volume fell by 4.4 L versus 2.3 L. PubMed 22982184