Teduglutide

Brand names: Gattex® (U.S.), Revestive® (Europe)

Mechanism of action: GLP-2 receptor agonist; Increases intestinal villus height and crypt depth; Enhances intestinal blood flow; Improves nutrient and fluid absorption; Reduces gastric acid secretion; Promotes intestinal adaptation

Approved indications: Treatment of adults and children (≥1 year) with short bowel syndrome who require parenteral support

Proposed indications: Intestinal failure; Crohn's disease (mucosal healing); Radiation enteritis; Intestinal adaptation after surgery

Administration: Subcutaneous injection — Once daily

Compare with: PlecanatideLinaclotide

Evidence rating: Grade A — Multiple randomized controlled trials and long-term extension studies support efficacy in short bowel syndrome.

Landmark trials: STEPS clinical trial program — Demonstrated significant reductions in parenteral nutrition and intravenous fluid requirements among adults with short bowel syndrome, with sustained benefits observed in long-term extension studies.

Common side effects: Abdominal pain, Injection-site reactions, Nausea, Abdominal distension, Headache

Serious risks: Potential for hyperplastic/neoplastic growth, requiring GI monitoring (Warnings and Precautions — not a boxed warning); Intestinal obstruction; Gallbladder and biliary disease; Pancreatic disease; Fluid overload

Drug interactions: May increase absorption of concomitant oral medications due to improved intestinal function. Monitor drugs with a narrow therapeutic index.

Monitoring: Fluid and electrolyte status, Liver function tests, Gallbladder and pancreatic function, Colonoscopy per prescribing recommendations, Nutritional status, Parenteral nutrition requirements

Legal status: Prescription required. This is an FDA-approved medication available only through a licensed prescriber — dosing is determined by your prescriber based on your medical history and is not provided here.

Regulatory status: FDA Approved • EMA Approved

Contraindications: Active or recently treated gastrointestinal malignancy — per prescribing information's Warnings and Precautions on the potential for hyperplastic/neoplastic growth, the GI tract should be evaluated before starting, and the drug should be discontinued if a GI malignancy is found.

Pregnancy & breastfeeding: Limited human data. Use only if the potential benefit justifies the potential risk. Exercise caution during breastfeeding.

Jeppesen PB, et al. (2012). Teduglutide Reduces Need for Parenteral Support Among Patients With Short Bowel Syndrome. Gastroenterology, 143(6), 1473–1481.e3. https://doi.org/10.1053/j.gastro.2012.09.007 Schwartz LK, et al. (2016). Long-term efficacy and safety of teduglutide in patients with short bowel syndrome. Clinical and Translational Gastroenterology, 7, e142.