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PP130-MON: Teduglutide for Patients with Short Bowel Syndrome. A Single Center Experience
S178
Poster presentations
had minimal requirements for PEG according our protocols. Enteral nutrition was administrated for a mean of 10.1 months with a mortality of 50% in the first 6 months. Conclusion: There is a delay of 5 years between diagnosis and PEG procedure, with a survival rate of 50% after 6 months, more studies are required for determining if an earlier PEG could improve survival rate in this group of patients. Disclosure of Interest: None Declared.
PP130-MON TEDUGLUTIDE FOR PATIENTS WITH SHORT BOWEL SYNDROME. A SINGLE CENTER EXPERIENCE A. Ukleja1 , A. Alvarez1 , K. Alvarez2 , L. Lara1 . 1 Gastroenterology, Cleveland Clinic Florida, Weston, United States; 2 Nutrition, Licda Nutrici´ on Clínica & Bari´ atrica, Guatemala City, Guatemala Rationale: Teduglutide (TG) was recently approved for treatment of parenteral support (PS) dependent patients with short bowel syndrome (SBS). Limited data is available regarding clinical results outside research protocols. Aims: To evaluate outcomes of SBS pts receiving TG and assess patients’ interest in TG therapy. Methods: Retrospective chart review was conducted. 19 SBS pts. were identified. Demographics, small bowel length, primary diagnosis, PS volume/duration, TG dose/ related complications were collected. Patients who received TG were included in final analysis. Results: 6 of 19 SBS pts received TG (4 F, 2 M); Mean age 45.8 yrs (26 71). SBS cause: Vascular 3, strangulation 1, multiple resections 2. SB length 30 120 cm. Colon present 4, stoma 3. TPN duration 1 14 yrs. PS volume 1 8 L/week. Duration TG therapy 1 12 months. Complications: bowel obstruction (SBO) 1, stoma swelling 2. TG discontinued 1, TG dose reduction 1. PS weaned off 4 pts. Volume reduction in 6. No TG use: 13 pts; reasons: recent cancer 2, recent surgery <12 months 1;, massive SB dilation 1, no approval 1, no interest in TG therapy 8. Conclusion: From our eligible SBS-pts only 6/14 (43.8%) received TG therapy and >50% of them expressed no interest in TG therapy. Four PS dependent patients discontinued PS completely on TG. All pts had >20% reduction in PS volume while on TG. All had significant reduction in stoma/stool output. TG was well tolerated. Further studies with a larger sample size are needed in SBS patients to assess clinical value of TG and address patient decision process regarding this therapy.
PP131-MON DARBEPOETIN ALFA DOSE REDUCED EFFECT BY THE ORAL ADMINISTRATION OF L-CARNITINE IN ELDERLY DIALYSIS PATIENTS H. Ogawa1 , T. Takahashi, M. Aono, Y. Sato. 1 Sato Junkanki Hospital, Matsuyama, Japan Rationale: 70 80% of plasma L-carnitine is eliminated per cycle of dialysis. We investigated the effects of oral L-carnitine administration on elderly dialysis patients. Methods: Seventy-four patients on HD aged 65 years or older who were taking oral L-carnitine (900 mg/day at 3 months after the start of administration, which was reduced to 300 mg/day from month 4) were classified as an inpatient group (patients admitted to hospitals or equivalent sites where the nursing staff can conduct robustly supervised administration; Group A, N = 29) and an outpatient group (Group B, N = 45). Free carnitine concentration, Hb, weekly darbepoetin alfa (abbreviated as DA) dosage, Alb, ChE, DW, and BMI were compared. Results: For Group A, mean age was 80.4±6.9 years. For Group B, mean age was 75.5±6.5 years. Before the start of oral carnitine administration, free carnitine concentration was 20.3±4.5 mmol/L in Group A and 20.8±4.2 mmol/L in Group B; Hb was 10.7±0.8 g/dl in Group A and 10.7±1.1 g/dl in Group B; weekly DA dosage was 21.7±11.6 mg in Group A and 22.4±23.3 mg in Group B. There were no significant differences between the groups with regard to these parameters. In Group A, free carnitine concentration was 113.0±54.5 mmol/L at 7 months, which were significantly higher than 81.8±38.4 mnmol/L at the same time in Group B (P < 0.05). Plasma concentration of Hb at the pre-administration time were unchanged in both groups. Weekly DA dosage was significantly reduced in Group A (21.7±11.6 mnmol/L vs 17.1±11.9 mnmol/L, p < 0.05), but was unchanged in Group B (22.4±23.3 mnmol/L vs 19.8±16.7 mnmol/L, ns), which suggested that compliance was insufficient. Conclusion: The strict oral administration of L-carnitine effectively reduced DA dosage. It is necessary to investigate other carnitine supplementation methods, such as an injection, in elderly patients on HD for whom compliance is insufficient. Disclosure of Interest: None Declared.
Disclosure of Interest: A. Ukleja Consultant for: NPS, A. Alvarez: None Declared, K. Alvarez: None Declared, L. Lara: None Declared.
Table (abstract PP130-MON): Characteristics of SBS pts who received TG therapy Pt
Age
Sex
SB length (cm)
Colon present
PS duration (years)
Volume (L/week)
PS reduction >20%
PS stopped
TG duration (months)
TG stopped
Complications
1 2 3 4 5 6
52 29 26 36 61 71
F F F M F M
90 ~30 70 50 ~120 90
N Y Y Y N Y
1.5 14 5 2 2 2
8 7.2 6.4 7.5 1 7
Y Y Y Y Y Y
N Y Y Y Y N
1 12 9 6 5 4
N N N N N Ya
Yb N N N Yb Ya
a
Bowel obstruction (SBO); b stoma swelling.
Poster presentations
had minimal requirements for PEG according our protocols. Enteral nutrition was administrated for a mean of 10.1 months with a mortality of 50% in the first 6 months. Conclusion: There is a delay of 5 years between diagnosis and PEG procedure, with a survival rate of 50% after 6 months, more studies are required for determining if an earlier PEG could improve survival rate in this group of patients. Disclosure of Interest: None Declared.
PP130-MON TEDUGLUTIDE FOR PATIENTS WITH SHORT BOWEL SYNDROME. A SINGLE CENTER EXPERIENCE A. Ukleja1 , A. Alvarez1 , K. Alvarez2 , L. Lara1 . 1 Gastroenterology, Cleveland Clinic Florida, Weston, United States; 2 Nutrition, Licda Nutrici´ on Clínica & Bari´ atrica, Guatemala City, Guatemala Rationale: Teduglutide (TG) was recently approved for treatment of parenteral support (PS) dependent patients with short bowel syndrome (SBS). Limited data is available regarding clinical results outside research protocols. Aims: To evaluate outcomes of SBS pts receiving TG and assess patients’ interest in TG therapy. Methods: Retrospective chart review was conducted. 19 SBS pts. were identified. Demographics, small bowel length, primary diagnosis, PS volume/duration, TG dose/ related complications were collected. Patients who received TG were included in final analysis. Results: 6 of 19 SBS pts received TG (4 F, 2 M); Mean age 45.8 yrs (26 71). SBS cause: Vascular 3, strangulation 1, multiple resections 2. SB length 30 120 cm. Colon present 4, stoma 3. TPN duration 1 14 yrs. PS volume 1 8 L/week. Duration TG therapy 1 12 months. Complications: bowel obstruction (SBO) 1, stoma swelling 2. TG discontinued 1, TG dose reduction 1. PS weaned off 4 pts. Volume reduction in 6. No TG use: 13 pts; reasons: recent cancer 2, recent surgery <12 months 1;, massive SB dilation 1, no approval 1, no interest in TG therapy 8. Conclusion: From our eligible SBS-pts only 6/14 (43.8%) received TG therapy and >50% of them expressed no interest in TG therapy. Four PS dependent patients discontinued PS completely on TG. All pts had >20% reduction in PS volume while on TG. All had significant reduction in stoma/stool output. TG was well tolerated. Further studies with a larger sample size are needed in SBS patients to assess clinical value of TG and address patient decision process regarding this therapy.
PP131-MON DARBEPOETIN ALFA DOSE REDUCED EFFECT BY THE ORAL ADMINISTRATION OF L-CARNITINE IN ELDERLY DIALYSIS PATIENTS H. Ogawa1 , T. Takahashi, M. Aono, Y. Sato. 1 Sato Junkanki Hospital, Matsuyama, Japan Rationale: 70 80% of plasma L-carnitine is eliminated per cycle of dialysis. We investigated the effects of oral L-carnitine administration on elderly dialysis patients. Methods: Seventy-four patients on HD aged 65 years or older who were taking oral L-carnitine (900 mg/day at 3 months after the start of administration, which was reduced to 300 mg/day from month 4) were classified as an inpatient group (patients admitted to hospitals or equivalent sites where the nursing staff can conduct robustly supervised administration; Group A, N = 29) and an outpatient group (Group B, N = 45). Free carnitine concentration, Hb, weekly darbepoetin alfa (abbreviated as DA) dosage, Alb, ChE, DW, and BMI were compared. Results: For Group A, mean age was 80.4±6.9 years. For Group B, mean age was 75.5±6.5 years. Before the start of oral carnitine administration, free carnitine concentration was 20.3±4.5 mmol/L in Group A and 20.8±4.2 mmol/L in Group B; Hb was 10.7±0.8 g/dl in Group A and 10.7±1.1 g/dl in Group B; weekly DA dosage was 21.7±11.6 mg in Group A and 22.4±23.3 mg in Group B. There were no significant differences between the groups with regard to these parameters. In Group A, free carnitine concentration was 113.0±54.5 mmol/L at 7 months, which were significantly higher than 81.8±38.4 mnmol/L at the same time in Group B (P < 0.05). Plasma concentration of Hb at the pre-administration time were unchanged in both groups. Weekly DA dosage was significantly reduced in Group A (21.7±11.6 mnmol/L vs 17.1±11.9 mnmol/L, p < 0.05), but was unchanged in Group B (22.4±23.3 mnmol/L vs 19.8±16.7 mnmol/L, ns), which suggested that compliance was insufficient. Conclusion: The strict oral administration of L-carnitine effectively reduced DA dosage. It is necessary to investigate other carnitine supplementation methods, such as an injection, in elderly patients on HD for whom compliance is insufficient. Disclosure of Interest: None Declared.
Disclosure of Interest: A. Ukleja Consultant for: NPS, A. Alvarez: None Declared, K. Alvarez: None Declared, L. Lara: None Declared.
Table (abstract PP130-MON): Characteristics of SBS pts who received TG therapy Pt
Age
Sex
SB length (cm)
Colon present
PS duration (years)
Volume (L/week)
PS reduction >20%
PS stopped
TG duration (months)
TG stopped
Complications
1 2 3 4 5 6
52 29 26 36 61 71
F F F M F M
90 ~30 70 50 ~120 90
N Y Y Y N Y
1.5 14 5 2 2 2
8 7.2 6.4 7.5 1 7
Y Y Y Y Y Y
N Y Y Y Y N
1 12 9 6 5 4
N N N N N Ya
Yb N N N Yb Ya
a
Bowel obstruction (SBO); b stoma swelling.