Short bowel syndrome is a rare condition that is normally caused by surgical removal of half or more of the small intestine to treat intestinal diseases, injury or defects present at birth. Patients usually suffer from severe diarrhoea, which leads to dehydration, malnutrition and weight loss.
The main treatment for short bowel syndrome is nutritional support, involving the use of oral rehydration solution, enteral and parenteral nutrition. Intestinal transplantation may be an option for some patients when other treatments have failed or who have complications from long-term parenteral nutrition.
Teduglutide is a glucagon-like peptide-2 analogue that increases villus height and crypt depth of the intestinal epithelium. In studies, it enhanced gastrointestinal fluid absorption to improve absorption of macronutrients and electrolytes, decreased stomal or faecal fluid and macronutrient excretion and enhanced key structural and functional adaptations in the intestinal mucosa. These structural adaptations were transient and returned to baseline levels within 3 weeks of discontinuing treatment.
Revestive must only be used by specialists and an adequate period must elapse between surgery and starting Revestive to allow intestinal adaptation to occur. A colonoscopy with polypectomy should be performed before starting and periodically during treatment, and Revestive should be discontinued if any malignancy is detected. Treatment with Revestive should be continued in patients who are successfully weaned off parenteral nutrition.
More information: NPS Pharmaceuticals