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  • Outcomes from a 12-Week, Op...
    Carter, Beth A., MD; Cohran, Valeria C., MD, MS; Cole, Conrad R., MD, MPH, MSc; Corkins, Mark R., MD; Dimmitt, Reed A., MD, MSPH; Duggan, Christopher, MD, MPH; Hill, Susan, MRCPCH, DM; Horslen, Simon, MB, ChB, FRCPCH; Lim, Joel D., MD; Mercer, David F., MD, PhD, FRCS(C); Merritt, Russell J., MD, PhD; Nichol, Peter F., MD, PhD; Sigurdsson, Luther, MD; Teitelbaum, Daniel H., MD; Thompson, John, MD; Vanderpool, Charles, MD; Vaughan, Juliana F., MD; Li, Benjamin, MS; Youssef, Nader N., MD; Venick, Robert S., MD; Kocoshis, Samuel A., MD

    The Journal of pediatrics, 02/2017, Letnik: 181
    Journal Article

    Objective To determine safety and pharmacodynamics/efficacy of teduglutide in children with intestinal failure associated with short bowel syndrome (SBS-IF). Study design This 12-week, open-label study enrolled patients aged 1-17 years with SBS-IF who required parenteral nutrition (PN) and showed minimal or no advance in enteral nutrition (EN) feeds. Patients enrolled sequentially into 3 teduglutide cohorts (0.0125 mg/kg/d n = 8, 0.025 mg/kg/d n = 14, 0.05 mg/kg/d n = 15) or received standard of care (SOC, n = 5). Descriptive summary statistics were used. Results All patients experienced ≥1 treatment-emergent adverse event; most were mild or moderate. No serious teduglutide-related treatment-emergent adverse events occurred. Between baseline and week 12, prescribed PN volume and calories (kcal/kg/d) changed by a median of −41% and −45%, respectively, with 0.025 mg/kg/d teduglutide and by −25% and −52% with 0.05 mg/kg/d teduglutide. In contrast, PN volume and calories changed by 0% and −6%, respectively, with 0.0125 mg/kg/d teduglutide and by 0% and −1% with SOC. Per patient diary data, EN volume increased by a median of 22%, 32%, and 40% in the 0.0125, 0.025, and 0.05 mg/kg/d cohorts, respectively, and by 11% with SOC. Four patients achieved independence from PN, 3 in the 0.05 mg/kg/d cohort and 1 in the 0.025 mg/kg/d cohort. Study limitations included its short-term, open-label design, and small sample size. Conclusions Teduglutide was well tolerated in pediatric patients with SBS-IF. Teduglutide 0.025 or 0.05 mg/kg/d was associated with trends toward reductions in PN requirements and advancements in EN feeding in children with SBS-IF. Trial registration ClinicalTrials.gov: NCT01952080 ; EudraCT: 2013-004588-30.