UEG's educational platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

UEG Week Berlin 2025 Recordings Gut Guide online

Rate for better recommendations!

Your feedback helps us show you more of what you like and less of what you dislike!

More of this!

We will show you more similar content.

Not for me!

We won't suggest this again.

Bookmark!

Save this content for later!

New to myUEG? Create an account! Log In with myUEG account

UEG Poster

Standard Poster

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Free for all myUEG account holders. Your access level is set automatically based on your occupation. Medical professionals get full access to all content. If you are a non-medical user, you can only access UEG Week content from congresses you attended.

Not sure what you can access? Learn more about account types.

Introduction

Medications are a primary treatment modality for high stool output (HSO) in patients with short bowel syndrome (SBS). Although practice guidelines¹ for management of HSO in patients with SBS are available, corresponding real-world data are lacking.

Aims & Methods

The aim of this study is to describe medication management of HSO in patients with SBS across different geographic regions. This is an international multicenter study utilizing a questionnaire survey. Thirty-three adult intestinal failure (IF) centers in Europe and North America were invited to participate and answer survey questions as one multidisciplinary team.

Results

The survey response rate was 91%. Loperamide was the most commonly used antimotility medication (90%), followed by codeine (20%). The median (range) of initial dose and highest dose of loperamide were 8 (2-24) and 28 (4-64) mg/day, respectively. Proton pump inhibitors (PPIs) were the most frequently used antisecretory medication (80%), followed by oral histamine H2-receptor antagonists (10%), and somatostatin analogues (10%). The median (range) of initial dose and highest dose of pantoprazole were 40 (20-80) and 80 (40-160) mg/day, respectively. Seventy percent of IF centers prescribed PPI indefinitely. Other therapeutic agents were utilized for management of HSO in real-world practice and usage varied based on patient intestinal anatomy (Table 1). Pancreatic enzymes were utilized in 20% of practices in patients with or without colon-in-continuity (CiC). In patients with CiC, bile acid binders were used in 30% of practices.

Table 1 Alternative therapeutic agents used in patients with short bowel syndrome*

Medications or agents	Without CiC Median % (range)	With CiC Median % (range)
Bile acid binders	0 (0-100)	30 (0-100)
Fiber (e.g., psyllium)	10 (0-90)	20 (0-90)
Pancreatic enzymes	20 (0-80)	20 (0-80)
Probiotics	0 (0-60)	10 (0-100)

*Excluding antimotility and antisecretory agents
Abbreviation: CiC, colon-in-continuity.

Conclusion

In accordance with published guidelines, loperamide and PPIs were commonly utilized by IF centers for medical management of HSO in patients with SBS. Our findings identified the use of loperamide doses exceeding guideline recommendations in real-world practice. Other therapeutic agents used by IF centers to manage HSO included pancreatic enzymes and bile acid binders, despite limited availability of supporting evidence.

References

¹Clin Nutr. 2021;40(9):5196-220.

THE REAL-WORLD MEDICATION MANAGEMENT OF HIGH STOOL OUTPUT IN PATIENTS WITH SHORT BOWEL SYNDROME: AN INTERNATIONAL MULTICENTER SURVEY

Narisorn Lakananurak 1, Elizabeth Wall 2, Hilary Catron 3, Lisa Moccia 4, Sophie Greif 5, Adela Delgado 6, Jean Herlitz 2, David F Mercer 7, Vanessa Kumpf 8, Mark Berner-Hansen 9, Leah Gramlich 10, Tim Vanuytsel 11

1 Chulalongkorn University, Bangkok, Thailand|||King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand

2 University of Chicago Medicine, Chicago, United States

3 University of Nebraska Medical Center, Omaha, United States

4 Cleveland Clinic, Cleveland, United States

5 Charité – Universitätsmedizin Berlin, Berlin, Germany

6 Royal Alexandra Hospital, Edmonton, Canada

7 University Of Nebraska Medical Center, Omaha, United States

8 Vanderbilt University Medical Center, Nashville, United States

9 Bispebjerg University Hospital of Copenhagen, Copenhagen, Denmark|||Zealand Pharma, Copenhagen, Denmark

10 University of Alberta, Edmonton, Canada

11 KU Leuven, Leuven, Belgium

Conference

UEG Week Copenhagen 2023

Topics

Small Intestine & Nutrition

Submission format

Abstract

Session

The small intestine: A hidden treasure! (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

EARLY RESPONSE TO GLEPAGLUTIDE, A NOVEL LONG-ACTING GLP-2 ANALOG, IN SHORT BOWEL SYNDROME PATIENTS WITH INTESTINAL FAILURE: RESULTS OF 24-WEEK PHASE 3 TRIAL

Not sure what you can access? Learn more about account types.

Introduction

Management of short bowel syndrome (SBS) patients with intestinal failure (IF) is multidisciplinary and multifactorial. The goal of treatment is to enhance oral/enteral nutrition as early as possible in a safe and well-tolerated manner. This can be achieved by increasing intestinal absorptive capacity to reduce parenteral support (PS) and in some patients avoid the need for central lines after achieving enteral autonomy. Glepaglutide is a novel long-acting GLP-2 analog in an aqueous formulation developed for subcutaneous (SC) weekly administration.

Aims & Methods

The aim of EASE (Efficacy and Safety Evaluation) SBS-1 trial was to assess the efficacy and safety of glepaglutide in reducing PS in SBS patients with IF. The design was a 29-center, placebo-controlled, randomized, parallel-group, double-blind, 24-week phase 3 trial. Adult SBS patients with chronic IF and requiring PS at least 3 days per week were eligible. Patients were randomized to SC injections of either 10 mg glepaglutide twice-weekly (TW), 10 mg glepaglutide once-weekly (OW), or placebo. PS volume requirements were adjusted using a predefined algorithm. Primary endpoint was change in PS volume from baseline to week 24 and two of key secondary endpoints were change in PS volume from baseline to week 12 and achieving enteral autonomy (complete weaning-off PS) at week 24.

Results

106 optimized stable patients were randomized and 96% completed the trial. Treatment arms were well balanced and as expected for demographics: mean age of 55 years and 57% were women. Similarly balanced for baseline characteristics: 51% with colon-in-continuity (CiC), mean PS volume requirement of 14.4 L/week; 33% and 58% of patients with mild to moderate hepatic and renal impairment, respectively. Glepaglutide TW treatment significantly reduced PS vs placebo (mean change of -5.13 vs -2.85 L/week; estimated difference of -2.28 L/week; p=0.0039) at 24 weeks. Significant reduction in PS with glepaglutide TW was observed by week 12 with mean change of -4.32 vs -1.90 L/week; estimated difference of -2.42 L/week; p=0.0019). These findings were preserved in both anatomical subgroups: patients without and with CiC. No statistically significant reduction in PS was observed with glepaglutide OW vs placebo at week 12 or 24. Enteral autonomy was achieved for 5 (14%) patients receiving glepaglutide TW and 4 (11%) patients receiving glepaglutide OW vs 0 patients receiving placebo. In a post-hoc analysis, circulating levels of citrulline, a marker for intestinal mucosal cell mass, increased and were sustained from baseline to week 4 and 24 with a ratio of 1.49 (p<0.0001) and 1.41 (p=0.0101) in glepaglutide TW treatment arm vs placebo, respectively. Treatment with glepaglutide was assessed to be safe with more adverse events reported in glepaglutide treatment arms vs placebo, primarily attributable to mild injection site reactions.

Conclusion

Treating SBS patients with chronic IF with glepaglutide was assessed to be safe, well tolerated and resulted in early (by 12 weeks of treatment) sustained reductions in PS needs including the achievement of enteral autonomy in a meaningful number of patients within 24 weeks. Data supports glepaglutide as a novel medical treatment option for the management of SBS patients that results in early and significant reductions in PS support.

Disclosure

Nothing to disclose

EARLY RESPONSE TO GLEPAGLUTIDE, A NOVEL LONG-ACTING GLP-2 ANALOG, IN SHORT BOWEL SYNDROME PATIENTS WITH INTESTINAL FAILURE: RESULTS OF 24-WEEK PHASE 3 TRIAL

Tim Vanuytsel 1, Ulrich-Frank Pape 2, Sukanya Subramanian 3, Francisca Joly 4, Geert J.A. Wanten 5, Georg Lamprecht 6, Marek Kunecki 7, Faqooq Rahman 8, Thor Schutt Svane Nielsen 9, Lykke Bjerglund Graff 9, Mark Berner-Hansen 9, David F Mercer 10, Palle Bekker Jeppesen 11

1 University Hospital, Leuven, Belgium

2 Asklepios Medical School, Berlin, Germany

3 MedStar Georgetown, Washington DC, United States

4 Hospital Beaujon, Clichy, France

5 Radboud University Nijmegen Medical Centre (Radboud UMCN), Nijmegen, Netherlands

6 University Medical Center Rostock, Rostock, Germany

7 M. Pirogow Hospital, Wolczanska, Poland

8 University College London Hospitals (UCLH), London, United Kingdom

9 Zealand Pharma A/S, Copenhagen, Denmark

10 Nebraska Medical Center, Nebraska, United States

11 Rigshospitalet, Copenhagen, Denmark

Event

UEG Week Copenhagen 2023

Topics

Hepatobiliary IBD Small Intestine & Nutrition

Submission format

Abstract

Session

Big steps for coeliac and short bowel

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

GLEPAGLUTIDE REDUCES NEED OF PARENTERAL SUPPORT OF FLUIDS, ELECTROLYTES, ENERGY AND MACRONUTRIENTS IN SHORT BOWEL SYNDROME PATIENTS: RESULTS FROM THE 52-WEEK OPEN-LABEL EASE SBS-4 STUDY

Not sure what you can access? Learn more about account types.

Introduction

Glepaglutide, a novel long-acting glucagon-like peptide-2 (GLP-2) analog, is currently in development for treatment of patients with short bowel syndrome (SBS) with intestinal failure (SBS-IF). GLP-2 facilitates intestinal adaptation, thereby enhancing intestinal absorptive capacity in SBS patients. Employing metabolic balance studies including patients with SBS-IF and intestinal insufficiency, 24 weeks of treatment with glepaglutide has recently been reported to numerically increase wet weight absorption by 398 g/day and energy absorption by 1038 kJ/day, as measured by bomb calorimetry¹. Here, the corresponding sustained effects of glepaglutide on the need for parenteral support (PS) in SBS-IF patients over 52-week treatment period are presented.

Aims & Methods

Patients received a once-weekly 10 mg subcutaneous injection of glepaglutide via a ready-to-use autoinjector. Prior to study visits, a 48-hour collection period at home was completed: Urine volumes were measured while adhering to a fixed drinking menu (individually determined before the first study visit). Adjustments to PS volume were guided by a prespecified algorithm: PS volume reduction equaled seven times the difference between observed and baseline urine volumes, when observed urine volumes were ≥10% higher than baseline. For the first 24 weeks, patients adhered to the fixed drinking menu; thereafter, beverage consumption was unrestricted intending to simulate usual living conditions. Changes from baseline to weeks 24 and 52 in PS volume and its content of electrolytes, energy and macronutrients were evaluated by post-hoc one-sample t-tests.

Results

10 patients were included: mean age 55 years, 5 females, 8 with SBS-IF, 8 without colon-in-continuity (CIC). Mean baseline PS volume was 2.55 L/day (SD=1.72). Mean PS volume was decreased by -0.76 L/day at week 24 (p=0.0285), corresponding to a -25% reduction from baseline (see table). By week 52, mean PS volume reduction amounted to -0.80 L/day, a -30% reduction from baseline (p=0.0106).
PS sodium and potassium decreased at weeks 24 and 52. PS calcium and magnesium showed numerical reductions.
PS energy content decreased by -859 kJ/day (–37% reduction) at week 24 (p=0.0038) and remained stable and low until week 52.
PS carbohydrate content was reduced by -702 kJ/day at week 24 (-42% reduction) and remained consistently low until week 52. Protein content decreased by -151 kJ/day (-36%) at week 24. PS lipid content showed a numerical reduction at weeks 24 and 52. Body weight and urine volume remained constant throughout the study.

		Week 24	95% CI and p-value	Week 52	95% CI and p-value
Volume (L/day)		-0.76	[-1.41 ; -0.11], p=0.0285	-0.80	[-1.33 ; -0.26], p=0.0106
Electrolytes (mmol/day)	Sodium	-68.0	[-128.4 ; -7.5], p=0.0326	-57.2	[-112.2 ; -2.3], p=0.0436
	Potassium	-8.4	[-14.6 ; -2.3], p=0.0145	-8.8	[-17.3 ; -0.3], p=0.0437
	Magnesium	-0.8	[-2.6 ; 0.9], p=0.3084	-1.4	[-2.9 ; 0.1], p=0.0594
	Calcium	-1.0	[-2.1 ; 0.1], p=0.0727	-1.2	[-2.5 ; 0.2], p=0.0800
Energy (kJ/day)		-859	[-1337 ; -382], p=0.0038	-866	[-1441 ; -291], p=0.0103
Macronutrients (kJ/day)	Carbohydrate	-702	[-995 ; -409], p=0.0008	-645	[-1089 ; -201], p=0.0120
	Lipid	-6	[-229 ; 217], p=0.9508	-81	[-264 ; 103], p=0.3244
	Protein	-151	[-269 ; -34], p=0.0188	-140	[-302 ; 22], p=0.0795

Table: Mean changes from baseline in PS volume and its content of electrolytes, energy and macronutrients, with 95 % confidence intervals and p-values.

Conclusion

Glepaglutide induced clinically meaningful, sustained reduction in the PS need, including fluids, electrolytes, energy and macronutrients at 52 weeks in SBS patients with and without CIC. These data are in alignment with glepaglutide-induced increases in intestinal absorptive capacity as demonstrated in state-of-art metabolic balance studies.

References

1 Pinar I, Nielsen T SS, Soldbro L, Berner-Hansen M, Jeppesen P B (2024). Changes in intestinal absorption following 24-weeks of treatment with glepaglutide in patients with short bowel syndrome. [Abstract submitted to the ESPEN 2024 Congress on Clinical Nutrition & Metabolism, Milan, Italy].

GLEPAGLUTIDE REDUCES NEED OF PARENTERAL SUPPORT OF FLUIDS, ELECTROLYTES, ENERGY AND MACRONUTRIENTS IN SHORT BOWEL SYNDROME PATIENTS: RESULTS FROM THE 52-WEEK OPEN-LABEL EASE SBS-4 STUDY

Ismail Pinar 1, Thor Schutt Svane Nielsen 2, Lise Soldbro 2, Mark Berner-Hansen 3, Palle Bekker Jeppesen 1

1 Rigshospitalet, Copenhagen Ø, Denmark

2 Zealand Pharma, Copenhagen, Denmark

3 Zealand Pharma, Copenhagen, Denmark|||Bispebjerg Hospital, Copenhagen, Denmark

Event

UEG Week Vienna 2024

Topics

Mechanisms & Personalised Medicine Neurogastroenterology & Motility Radiology & Imaging Small Intestine & Nutrition

Submission format

Abstract

Session

Short bowel syndrome

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

UEG Poster

Standard Poster

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

Introduction

Long-term antithrombotic therapy is recommended in short bowel syndrome (SBS) caused by acute mesenteric ischemia (AMI). However, evidence-based recommendations on drug choice, duration and monitoring of treatment are lacking. Also, guidelines are based on data on other artery diseases and overlook the altered drug absorption in patients with SBS. To understand current practices, we aimed to assess the long-term antithrombotic management of AMI.

Aims & Methods

An online survey was sent to centers contributing to the chronic intestinal failure database of the HAN-CIF (Home Artificial Nutrition – Chronic Intestinal Failure) special interest group of ESPEN (European Society on Clinical nutrition and Metabolism), treating patients with SBS post-AMI. The survey featured 10 cases varying in postsurgical intestinal anatomy, revascularization and etiology and focused on drug class, administration route, duration and monitoring of antithrombotic therapy.

Results

The survey was completed by 43 centers. In case of idiopathic AMI leading to SBS, anticoagulation (65.1% of all physicians) or antiplatelet (32.6%) therapy were mostly prescribed (Figure 1; jejunocolic anastomosis, idiopathic). Antiplatelet therapy was prescribed more often to patients with type 3 anatomy (37.2%, largest absorptive capacity) than to other anatomy groups (30.2 and 32.6% in type 1 and 2 respectively). Antiplatelet drugs (39.5%) or combination therapy (18.6%) were more commonly prescribed in case of revascularization compared to no revascularization (32.6% or 2.3% respectively). Anticoagulants were very common in patients with atrial fibrillation (90.7%), venous thrombosis (95.3%) and antiphospholipid syndrome (83.7%). More antiplatelet drugs (27.9%) or combination therapy (18.6%) were preferred with concomitant peripheral artery disease. In hypovolemic shock, no therapy (41.9%) or anticoagulants (51.2%) were common.
Parenteral drugs were more prescribed to patients with type 1 anatomy (51.2% of all physicians; lowest absorptive capacity) than to patients with type 2 (44.2%) or 3 (20.9%) anatomy.
Antiplatelet drugs were mainly prescribed lifelong (94.7% of this drug class), while anticoagulants were prescribed for 6 (19.4%) to 12 (16.1%) months or lifelong (51.6%), irrespective of anatomy, revascularization or etiology.
Vitamin K antagonists were consistently monitored, whereas aspirin was not. Monitoring of subcutaneous low molecular weight heparins (no monitoring, 36.8% - always monitoring, 42.1% - in specific circumstances, 21.0%) and non-vitamin K oral anticoagulants varied (no monitoring, 50.0%).

Conclusion

In a case-based survey, anticoagulant versus antiplatelet drug choice depended on the anatomy, revascularization and etiology. However, there was a high variability in case of idiopathic AMI. Administration route depended on anatomy. More detailed practice guidelines are needed.

Disclosure

TV has participated in advisory boards, as a consultant and/or as a speaker on behalf of Boehringer Ingelheim, Bayer, Daiichi Sankyo, BMS/Pfizer, Sanofi Aventis, and Leo Pharma

EXAMINING LONG-TERM ANTITHROMBOTIC TREATMENT PATTERNS IN PATIENTS WITH SHORT BOWEL SYNDROME POST ACUTE MESENTERIC ISCHEMIA: INSIGHTS FROM AN INTERNATIONAL SURVEY

Barbara Deleenheer 1, Cristina Cuerda 2, Palle Bekker Jeppesen 3, Francisca Joly 4, Simon Lal 5, Georg Lamprecht 6, Mundi Manpreet 7, Loris Pironi 8, Kinga Szczepanek 9, Thomas Vanassche 10, Lorenz Van der Linden 11, André Van Gossum 12, Geert J.A. Wanten 13, Tim Vanuytsel 11

1 KU Leuven, Leuven, Belgium|||University Hospitals Leuven, Leuven, Belgium|||University Hospitals Leuven, Leuven, Belgium

2 Hospital General Universitario Gregorio Marañón, Madrid, Spain

3 Rigshospitalet, Copenhagen, Denmark

4 Beaujon Hospital Service de Gastroenterologie, Clichy, France

5 Salford Royal Foundation Trust, Salford, United Kingdom

6 Rostock University Medical Center, Rostock, Germany

7 Mayo Clinic, Rochester, United States

8 University of Bologna S. Orsola-Malpighi Hospital, Bologna, Italy

9 Stanley Dudrick’s Memorial Hospital, Skawina, Poland

10 University Hospitals Leuven, Leuven, Belgium

11 KU Leuven, Leuven, Belgium|||University Hospitals Leuven, Leuven, Belgium

12 Hôpital Erasme, University of Brussels, Bruxelles, Belgium

13 Radboud University Nijmegen, Nijmegen, Netherlands

Conference

UEG Week Vienna 2024

Topics

Small Intestine & Nutrition

Submission format

Abstract

Session

SMALL INTESTINAL (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

Summary: Untangling malabsorption in dysmotility and short bowel syndrome

Tim Vanuytsel 1

1 KU Leuven, Leuven, Belgium

Event

UEG Postgraduate Teaching Programme Berlin 2025

Topics

Neurogastroenterology & Motility Small Intestine & Nutrition

Session

Untangling malabsorption in dysmotility and short bowel syndrome

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

THE LONG-ACTING GLP-2 ANALOG APRAGLUTIDE PROVIDES CLINICAL BENEFIT FOR PATIENTS WITH SHORT BOWEL SYNDROME WITH INTESTINAL FAILURE AND COLON IN CONTINUITY AT 52 WEEKS

Not sure what you can access? Learn more about account types.

Introduction

Short bowel syndrome (SBS) is a rare gastrointestinal condition with a high risk of developing intestinal failure (SBS-IF) and need for parenteral support (PS). Glucagon-like peptide-2 (GLP-2) analogs stimulate adaptation of the remaining gut resulting in increased intestinal absorption and reduced PS needs. Extensive literature is available on the effect of teduglutide in patients (pts) without a remaining colon. However, in SBS-IF with a colon-in-continuity (CiC), where there is less dependency on IV fluid compared to calories, the impact of GLP-2 analogs is much less established. Apraglutide (APRA) is a novel, long-acting GLP-2 analog in development for SBS-IF.

Aims & Methods

This multicenter, open-label, phase 2 study in SBS-IF-CiC aims to investigate the safety and efficacy of APRA in reducing PS needs at 52 weeks (wks). STARS Nutrition is a 52-w study in adult pts with SBS-IF-CiC receiving once-weekly subcutaneous APRA injections (5 mg). Metabolic balance studies were performed at baseline and 4 wks with stable PS, followed by a 48-wk PS adjustment period. During monthly 48h fluid balance assessments, oral fluid intake was kept constant by adhering to an individual predefined drinking menu while urine was collected. PS was reduced according to a pre-defined algorithm if an increase in mean daily urinary output of ≥10% was observed. Safety was the primary endpoint. Secondary endpoints included changes in weekly PS volume, energy content, and PS days, and proportion of clinical responders (PS reduction of ≥20%). Data are presented as mean (95% CI) unless specified otherwise. Nominal p-values are calculated using paired T-tests with significance set at 0.05.

Results

Nine pts were included and comprise the full study population. Small bowel length was 19 (range 0-50) cm and 79 (range 43-100) % of the colon was in continuity. Pts had baseline PS needs of 10 (range 4-21) L distributed over 5.2 (range 3 – 7) days/wk. APRA had an acceptable safety profile, consistent with previous data. All pts experienced ≥1 adverse event (AE) after initiating APRA; a total of 127 AEs was reported. Three pts experienced serious AEs. APRA was interrupted for 1 wk in one patient with acute cholangitis; APRA was restarted and successfully continued to study completion. PS-related outcomes are presented in Table 1. Absolute weekly PS volume decreased significantly by -4702 (-6539 – -2865) mL/wk (p=0.0004). Accordingly, PS energy content significantly decreased by -3510 (-4991 – -2029) kcal/wk (p=0.0006). All pts qualified as clinical responders. Seven pts (78%) achieved ≥1 day off PS of whom two pts (22%) reached enteral autonomy. Pts gained an additional 2.1 (0.7 – 3.6) days off per wk. Body weight and daily urine output remained constant despite PS reductions.

Table 1 Parenteral support related outcomes after 24 and 52 weeks of apraglutide treatment; mean (95% CI); * p<0.05.

	Baseline	24 weeks	52 weeks
Actual weekly PS volume (mL/week)	9919 (5791 – 14 047)	6409 (2721 – 10 096) p=0.0005*	5217 (1935 – 8499) p=0.0004*
PS energy content (kcal/week)	7938 (4832 – 11 044)	5174 (2505 – 7844) p=0.0019*	4428 (2236 – 6620) p=0.0006*
Weight (kg)	57.7 (54.1 – 61.3)	59.3 (55.5 – 63.1) p=0.0327*	55.9 (51.7 – 60.2) p=0.1355
Oral fluid intake (mL/day)	1604 (1335 – 1874)	1604 (1335 – 1874)	1604 (1335 – 1874)
Daily urinary output (mL)	1511 (1182 – 1840)	1673 (1178 – 2168) p=0.2397	1453 (1121 – 1785) p=0.5956

Conclusion

APRA has an acceptable safety profile and significantly reduces PS needs in pts with SBS-IF-CiC resulting in days without PS. STARS Nutrition is the first study prospectively showing evidence for clinical benefit of a long-acting GLP-2 analog in SBS-IF-CiC.

Disclosure

PBJ has received grants/research support/honoraria or consultation fees from Albumedix A/S, ArTara Therapeutics, Bainan Biotech, Baxter, Coloplast, Ferring, Fresenius Kabi, GLyPharma, Naia Pharma, NPS Pharmaceuticals, Shire, Takeda, The Novo Nordisk Foundation, Therachon, VectivBio and Zealand Pharma.
FJ has received grants/research support/honoraria or consultation fees from Baxter, Fresenius Kabi, Nestlé Health Sciences, BBraun, Theradial, Mayoli, Biocodex, mobile3e Consulting, Carembouche, NPS Pharmaceuticals, Shire, Takeda, Therachon, VectivBio and Zealand Pharma.
TV has served on the speaker bureau for Fresenius Kabi, Remedus, Takeda, VectivBio and Zealand Pharma. TV has provided clinical advice to Baxter, Shire, Takeda, VectivBio, Zealand Pharma. TV has received research grants from Takeda and VectivBio.
This research was supported by VectivBio. FB, CL and NNY are employees of VectivBio.

THE LONG-ACTING GLP-2 ANALOG APRAGLUTIDE PROVIDES CLINICAL BENEFIT FOR PATIENTS WITH SHORT BOWEL SYNDROME WITH INTESTINAL FAILURE AND COLON IN CONTINUITY AT 52 WEEKS

Astrid Verbiest 1, Mark Krogh Hvistendahl 2, Federico Bolognani 3, Carrie Li 3, Nader N. Youssef 3, Palle Bekker Jeppesen 2, Francisca Joly 4, Tim Vanuytsel 5

1 University of Leuven, Leuven, Belgium|||University Hospitals Leuven, Leuven, Belgium

2 Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

3 VectivBio AG, Basel, Switzerland

4 Hôpital Beaujon, Clichy, France

5 University Hospitals Leuven, Leuven, Belgium|||University of Leuven, Leuven, Belgium

Event

UEG Week Copenhagen 2023

Topics

IBD Small Intestine & Nutrition

Submission format

Late-Breaking Abstract

Session

Breakthroughs in IBD treatment and outcomes: Late-breaking abstracts

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

UEG Poster

Standard Poster

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

Introduction

Concerns regarding colorectal cancer in short bowel syndrome (SBS) patients receiving teduglutide (TED) treatment have led to the recommendation of colonoscopy for screening and surveillance.^1,2 While there are reports of new small bowel polyps in TED patients, data on small bowel cancer risk and surveillance are lacking.^3,4 This study aims to evaluate the feasibility and effectiveness of using double-balloon enteroscopy (DBE) for surveillance in SBS patients undergoing TED treatment.

Aims & Methods

Data from patients with SBS in TED treatment who underwent DBE within a year of starting TED at a tertiary referral center for enteroscopy between December 2019 and October 2023 were collected. The primary endpoints were technical success, adverse events, and total enteroscopy rates. Secondary endpoints included the incidence of small bowel polyps and residual small bowel length measurement.

Results

Nine patients (7 female, median age 65.5, IQR 58-79) with SBS (22% type 1, 55.6% type 2, 22.2% type 3-SBS) underwent DBE (10 anterograde, 2 retrograde) under procedural sedation. Crohn’s disease (33.3%) and post-surgical complications (33.3%) were the most frequent causes of SBS. The median interval from TED prescription to DBE surveillance was 9.1 months (IQR 3.2-32.9). The median depth of maximal insertion was 85 cm (IQR 50-187). No adverse events occurred during all the procedures. The total enteroscopy rate was 75% (80% [8/10] of anterograde DBEs, 50% [1/2] of retrograde DBEs). Panenteric DBE allowed the estimation of small bowel residual length in all cases (2/2) where this important clinical information was unknown and revealed a different residual small bowel length compared to surgery in 44% of patients. No small bowel malignancies were detected during the study period.

Conclusion

DBE surveillance for small bowel malignancy in SBS patients undergoing TED treatment is feasible and effective. Total enteroscopy can be frequently achieved with a single endoscopy in these patients, allowing easy oncologic surveillance.

References

1. Revestive (teduglutide). Summary of product characteristics. Takeda; August 2022. Accessed 23 March 2024. https://www. medicines.org.uk/emc/product/3382/smpc
2. Pironi L, Allard JP, Joly F, et al. Use of teduglutide in adults with short bowel syndrome-associated intestinal failure. Nutr Clin Pract 2024;39:141-153.
3. Pevny S, Pape UF, Elezkurtaj S, et al. De Novo Development of Distal Jejunal and Duodenal Adenomas After 41 Months of Teduglutide Treatment in a Patient With Short-Bowel Syndrome: A Case Report. JPEN J Parenter Enteral Nutr 2021;45:652-656.
4. Ukleja A, Alkhairi B, Bejarano P, et al. De Novo Development of Hamartomatous Duodenal Polyps in a Patient With Short Bowel Syndrome During Teduglutide Therapy: A Case Report. JPEN J Parenter Enteral Nutr 2018;42:658-660.

ENDOSCOPIC SMALL BOWEL SURVEILLANCE IN PATIENTS WITH SHORT BOWEL SYNDROME IN TREATMENT WITH TEDUGLUTIDE

Andrea Sorge 1, Lucia Scaramella 2, Veronica Smania 3, Nicoletta Nandi 3, Andrea Costantino 2, Marco Michelon 3, Tommaso Pessarelli 3, Maurizio Vecchi 4, Gian Eugenio Tontini 4, Luca Elli 5

1 University of Milan, Milan, Italy|||Ghent University Hospital, Ghent, Belgium

2 Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy

3 University of Milan, Milan, Italy

4 Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico University of Milan, Milan, Italy|||University of Milan, Milan, Italy

5 Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico University of Milan, Milan, Italy

Conference

UEG Week Vienna 2024

Topics

Small Intestine & Nutrition

Submission format

Abstract

Session

SMALL INTESTINAL (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

UEG's educational platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

Most popular content

Rate for better recommendations!