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Colon polyps in patients with short bowel syndrome before and after teduglutide: post hoc analysis of the STEPS study series

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Authors

  • David Armstrong
  • Alastair Forbes
  • Palle Bekker Jeppesen
  • Hak-Myung Lee
  • Peter Nagy
  • Douglas L. Seidner

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Abstract

Background & Aims: Teduglutide, a GLP-2 analogue, promotes intestinal growth and is approved for the treatment of short bowel syndrome and intestinal failure (SBS-IF).1,2 Colonoscopy is recommended before and after teduglutide therapy but there are few data on the development of colorectal polyps in this population. The aim of this study is to report the occurrence of colorectal polyps in adult patients with SBS-IF who received teduglutide in clinical studies conducted to-date. Methods: A post hoc analysis of the completed Study of Teduglutide Effectiveness in Parenteral Nutrition-Dependent Short Bowel Syndrome Subjects (STEPS) clinical study series (NCT00798967, EudraCT 2008-006193-15; NCT00930644, EudraCT 2009-011679-65; NCT01560403) evaluated electronic case report form data for baseline colonoscopies (performed before treatment) and for surveillance or end-of-study (performed after treatment with teduglutide 0.05 mg/kg/day for 24 and 36 months) procedures. Results: Of the 98 patients in the STEPS studies population, 73 patients had a baseline colonoscopy and 50 patients had a surveillance/end-of-study colonoscopy. Colon polyps were reported at baseline in 12% (9/73) of patients and at the surveillance/end-of-study in 18% (9/50) of patients. Of these patients, two had polyps both at baseline and at the surveillance/end-of-study. Histology, available for seven samples, reported no malignancy. One patient had serrated and 4 patients had tubular adenomas. Conclusion: These data support recommendations for colonoscopic screening before teduglutide therapy and subsequent on-therapy colonoscopic surveillance, for patients with SBS-IF. Further studies are required to assess the risk of polyp formation in these patients with SBS-IF and the most appropriate colon polyp surveillance strategies.

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Original languageEnglish
JournalClinical Nutrition
Early online date23 Aug 2019
DOIs
Publication statusE-pub ahead of print - 23 Aug 2019
Peer-reviewedYes

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