Teduglutide: Uses, Mechanism, and Side Effects

For people living with short bowel syndrome who depend on parenteral support, reducing that dependence is often the central goal of treatment. Teduglutide is a lab-made version of a gut hormone designed to help the intestine work more efficiently.

Key takeaways

• Teduglutide is a GLP-2 analog sold under the brand name Gattex.
• It is approved for adults and children one year and older with short bowel syndrome who depend on parenteral support.
• More than 50 clinical trials have examined teduglutide, including completed Phase 3 studies in Japanese patients.
• The most reported adverse events involve weight changes, gastrointestinal symptoms, and vascular device infections.
• The label does not carry a boxed warning.

What Teduglutide Is

Teduglutide is an analog of human glucagon-like peptide-2 (GLP-2), a hormone normally released by cells in the distal intestine. It works by binding to GLP-2 receptors found on specific intestinal cells, including enteroendocrine cells and enteric neurons. Through this binding, teduglutide increases blood flow to the intestine and portal system and reduces stomach acid secretion. These actions are thought to support the intestine's ability to absorb nutrients and fluids.

What Teduglutide Is Approved For

Teduglutide, marketed as Gattex, is approved for adults and pediatric patients one year of age and older who have short bowel syndrome (SBS) and depend on parenteral support. It is classified as a GLP-2 analog. The label does not carry a boxed warning.

What the Evidence Shows

Teduglutide has been studied in more than 50 registered clinical trials. Among these, a completed Phase 3 trial evaluated its use in Japanese children with short bowel syndrome aged four months or older, and a separate completed Phase 3 study examined its effects in Japanese adult participants with the condition. A third Phase 3 trial, exploring teduglutide's effect on temporary ileostomy function, was withdrawn before completion.

Reported Side Effects

Reported safety data for teduglutide reflect counts of adverse event reports, not confirmed incidence or proof of causation. The most frequently reported issues include changes in body weight, both decreased (1,267 reports) and increased (882 reports). Gastrointestinal symptoms are also common, with nausea (1,106 reports), abdominal pain (1,070), and diarrhoea (1,061) among the most reported terms. Other frequently reported issues include vascular device infection (1,178 reports), dose omission issues (1,074), and dehydration (876 reports), patterns that may reflect the underlying condition and its management alongside the drug itself.