Products
Teduglutide is commercially available as a powder and solvent for solution for injection (Revestive, USA: Gattex). It was approved in the EU and US in 2012 and in many countries in 2016.
Structure and properties
Teduglutide is an analog of the human polypeptide glucagon-like peptide-2 (GLP-2), which is secreted by L cells in the intestine. It consists of 33 amino acids and has a molecular mass of 3752 kDa. At position 2 of the -terminus, an alanine has been replaced by a glycine. This has the effect of making teduglutide resistant to the degrading enzyme dipeptidyl peptidase-4 (DPP-4), resulting in an increase in half-life to about two hours (instead of about 7 minutes). Sequence of teduglutide: His-Gly-Asp-Gly-Ser-Phe-Ser-Asp-Glu-Met-Asn-Thr-Ile-Leu-Asp-Asn-Leu-Ala-Ala-Arg-Asp-Phe-Ile-Asn-Trp-Leu-Ile-Gln-Thr-Lys-Ile-Thr-Asp.
Effects
Teduglutide (ATC A16AX08) increases intestinal and portal blood flow, inhibits gastric acid secretion, delays gastric emptying, improves nutrient absorption, and normalizes intestinal mucosal growth. It increases intestinal villus height and intestinal crypt depth.
Indications
For the treatment of adults with short bowel syndrome who are dependent on parenteral nutrition.
Dosage
According to the SmPC. The drug is usually injected subcutaneously once daily. The site should be changed daily. Do not inject intravenously or intramuscularly!
Contraindications
- Hypersensitivity
- Active gastrointestinal malignancy
- History of malignant disease of the gastrointestinal tract, including the hepatobiliary system, in the past five years.
For complete precautions, see the drug label.
Interactions
Teduglutide may affect the absorption of other drugs.
Adverse effects
The most common potential adverse effects include abdominal pain, bloating, respiratory tract infections, nausea, injection site reactions, headache, vomiting, and peripheral edema. Gastrointestinal complications of the stoma may occur in patients with stomas.