Health Technology Brief

supporting sound, evidence-based decision making

Teduglutide (Gattex; Shire-NPS Pharmaceuticals Inc.) to Reduce Parenteral Support Requirements in Adults with Short Bowel Syndrome

December 27, 2017

Health Problem: Short bowel syndrome (SBS) is a rare malabsorptive condition in which the bowel is anatomically or functionally inadequate to meet absorptive nutritional needs. The goal of SBS therapy is to optimize enteral autonomy and reductions in parenteral support (PS) requirements, which is associated with morbidity, complications, reduced quality of life, and high cost.

Technology Description: Teduglutide is a recombinant glucagon-like peptide (GLP-2) that is approved by the Food and Drug Administration for the treatment of adult patients with SBS who are dependent on PS. The once-daily dose of 0.05 milligram/kilogram is given subcutaneously in alternating sites in the abdomen or arms.

Controversy: One major controversy regarding teduglutide is the cost-effectiveness of long-term teduglutide treatment of adult patients with SBS who are PS dependent. Additional controversies related to teduglutide administration include uncertainty regarding patient selection criteria, potential for use earlier (e.g., < 12 months post-start of intestinal failure) in the adaptation process, and its long-term safety, particularly with respect to malignancies and off-teduglutide complications.

Key Questions:

  • Is teduglutide effective in reducing or eliminating PS requirements in adult patients with SBS?
  • How does teduglutide therapy compare with other treatments for SBS?
  • Is teduglutide therapy safe?
  • Have definitive patient selection criteria been identified for teduglutide therapy in adults with SBS?