The Polish Intestinal Failure Centres' consensus on the use of teduglutide for the treatment of short bowel syndrome

- In the present study, we proposed working criteria for the clinical use of teduglutide in patients with intestinal failure.
- The criteria justified its use from medical and economic perspectives.
- There are two main groups of patients with intestinal failure who can benefit from this therapy: patients with good prognosis, when weaning off is possible; and those with poor prognosis due to liver failure.

ObjectiveTeduglutide is an active, glucagon-like peptide (GLP)-2 analog with proven clinical efficacy regarding intestinal adaptation in patients with short bowel syndrome (SBS). There are two factors that preclude its reimbursement, and thereby, its availability: its cost (reaching ∼$300,000/y)-which significantly exceeds the cost of home parenteral nutrition (HPN) in most countries-and the lack of clear guidelines. The aim of this study was to create evidence-based working criteria for the use of teduglutide that could be used in clinical settings.MethodsExperts from the Polish Network of Intestinal Failure Centers analyzed available research and considered experience on the topic of HPN and intestinal failure to create guidelines.ResultsExperts agreed that there are two groups of HPN patients who can benefit from therapy with a GLP-2 analog: those with a good prognosis (in whom complete weaning from HPN may be possible) and those with a poor prognosis (the therapy would be lifesaving). Patient criteria comprise the following: inclusion and exclusion criteria, parameters that can be used for monitoring, outcome measures, and the rationale for the termination of the treatment.ConclusionsIt was possible to describe inclusion criteria for both patient groups that justify the use of teduglutide from medical and economic perspectives.