Effectiveness, safety, and quality of life outcomes of teduglutide treatment in adult patients with short bowel syndrome-associated intestinal failure: A systematic literature review of real-world studies.

BACKGROUND: Short bowel syndrome-associated intestinal failure (SBS-IF) results from a reduction in the small intestine length, leading to parenteral nutrition and/or intravenous fluids (PN/IV) dependence. Teduglutide can reduce reliance on PN/IV. Previous teduglutide systematic reviews are limited, including only data from studies suitable for meta-analysis. Here, we aim to summarize the broader literature describing the real-world outcomes of adults with SBS-IF. METHODS: We conducted a systematic literature review in the Ovid Embase and MEDLINE databases to April 9, 2024, to identify publications reporting effectiveness, health-related quality of life (HRQoL), and/or safety of teduglutide in adults with SBS-IF in real-world clinical practice. Key conference proceedings were also searched. RESULTS: Of 645 publications identified, 31 publications describing 26 unique real-world studies were included. The number of patients per study ranged from 6 to 669. All 13 studies presenting infusion frequency reported an improvement with teduglutide. In total, 21/22 studies reporting PN/IV volume observed improvement with teduglutide. Patient proportion attaining enteral autonomy ranged from 10.5% to 100% at the last time point reported (21 studies). Teduglutide showed effectiveness across anatomic groups. Improvements were observed in four studies reporting HRQoL. Safety was reported in 17 studies; the most frequently reported adverse events included abdominal pain/cramping, nausea, injection-site reactions, catheter-related sepsis/infection, and stoma complications. CONCLUSION: This systematic review summarizes 10 years of real-world evidence on the effectiveness, including HRQoL, and safety of teduglutide in treating adults with SBS-IF in clinical practice, across phenotypic anatomic groups including patients with stomas and patients with colon in continuity.