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Gastroenterology Research and Practice
Volume 2009 (2009), Article ID 425759, 9 pages
http://dx.doi.org/10.1155/2009/425759
Clinical Study

Short Bowel Patients Treated for Two Years with Glucagon-Like Peptide 2 (GLP-2): Compliance, Safety, and Effects on Quality of Life

1Department of Gastroenterology, Copenhagen University Hospital (Rigshospitalet), 2121 Copenhagen, Denmark
2Department of Anesthesia, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
3Department of Biomedical Sciences, The Panum Institute, 2200 Copenhagen, Denmark
4Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark

Received 24 March 2009; Accepted 29 May 2009

Academic Editor: Karel Geboes

Copyright © 2009 P. B. Jeppesen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and aims. Glucagon-like peptide 2 (GLP-2) has been shown to improve intestinal absorption in short bowel syndrome (SBS) patients in a short-term study. This study describes safety, compliance, and changes in quality of life in 11 SBS patients at baseline, week 13, 26, and 52 during two years of subcutaneous GLP-2 treatment, 400 microgram TID, intermitted by an 8-week washout period. Methods. Safety and compliance was evaluated during the admissions. The Sickness Impact Profile (SIP), Short Form 36 (SF 36), and Inflammatory Bowel Disease Questionnaire (IBDQ) evaluated quality of life. Results. The predominant adverse event was transient abdominal discomfort in 5 of 11 patients, but in 2, both suffering from Crohns disease, it progressed to abdominal pain and led to discontinuation of GLP-2 treatment. One had a fibrostenotic lesion electively resected at the jejuno-ascendo-anastomosis. The investigator excluded a patient due to unreliable feedback. Stoma nipple enlargement was seen in all 9 jejunostomy patients. Reported GLP-2 compliance was excellent (>93%). GLP-2 improved the overall quality of life VAS-score ( 4 . 1 ± 2 . 8  cm versus 6 . 0 ± 2 . 4  cm, 𝑃 < . 0 1 ), the overall SIP score ( 1 0 . 3 ± 8 . 9 % versus 6 . 2 ± 9 . 5 %, 𝑃 < . 0 0 1 ), the mental component of the SF-36 ( 4 5 ± 1 3 % versus 5 3 ± 1 1 %, 𝑃 < . 0 5 ), and the overall IBDQ score ( 5 . 1 ± 0 . 9 versus 5 . 4 ± 0 . 9 , 𝑃 < . 0 0 7 ) in the 8 patients completing the study. Conclusions. Long-term treatment with GLP-2 is feasible in SBS patients, although caution must be exercised in patients with a history of abdominal pain. Although conclusions cannot be made in a noncontrolled trial, the high reported compliance might reflect a high treatment satisfaction, where the clinical benefits of GLP-2 may outweigh the discomforts of injections.