Valeria Cohran, MD, discusses teduglutide response in children with SBS-IF

At the 2025 North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), Valeria C. Cohran, MD, Medical Director, Intestinal Rehabilitation and Transplantation; Attending Physician, Gastroenterology; Professor of Pediatrics, Northwestern University Feinberg School of Medicine, presented data from the abstract "Characteristics Associated With Response to Teduglutide Treatment in Children With Short Bowel Syndrome–Associated Intestinal Failure: A Post Hoc Analysis of Long-Term Extension Studies."

“The reason we wanted to look at this study was to evaluate the characteristics of children with short bowel syndrome and intestinal failure by looking at their response to teduglutide — trying to see what certain characteristics may predict who’s going to be a responder to this medication,” Cohran explained.

The post hoc pooled analysis included 69 pediatric patients across two open-label, multicenter, phase 3 long-term extension studies. Among those analyzed, 33.3% were consistent responders—achieving at least a 20% reduction in PN/IV dependency—and 26.1% attained sustained enteral autonomy. Significant predictors of improved response included older age, longer time since diagnosis, and greater length of remaining small intestine.

Cohran noted that intestinal length plays a key role in determining outcomes: “We know that there’s data showing patients who have longer intestinal length remaining tend to be more likely to be tapered from TPN. So, if you have more length, you’re being treated with this drug, and your intestine is responding to it — increasing your absorption and your ability to absorb calories and fluids — it’s going to make it more likely that you’re able to be successfully tapered from TPN.”

She also highlighted the potential influence of the ileocecal valve. “I think we do know there’s some conflicting data out there about whether or not the ileocecal valve predicts a better outcome,” she said. “There’s some data that says yes, some that says maybe not. In this instance, it did show improvement if they had an ileocecal valve. In this instance, it did show an improvement if they had an ileocecal valve."

Cohran emphasized that while longer intestinal length often leads to better adaptation, patients with less bowel can still achieve success. “Another thing to keep in mind is that longer length does predict, in this paper, a better outcome in terms of adaptation,” she said. “That doesn’t mean, though, that you can’t have less bowel and still be tapered off.”

She added that, “We have patients reported to have as little as 30 centimeters — even without teduglutide, as little as 25 centimeters — and still be tapered from TPN. It simply depends on the quality of the bowel.”

Cohran concluded that further research and larger patient cohorts are needed to refine predictors of response. “We need longer-term studies, and as more patients are treated with this drug, that’s going to allow us to have more information about who is going to be a better responder to this agent,” she said.

Reference:

Cohran V, et al. CHARACTERISTICS ASSOCIATED WITH RESPONSE TO TEDUGLUTIDE TREATMENT IN CHILDREN WITH SHORT BOWEL SYNDROME-ASSOCIATED INTESTINAL FAILURE: A POST HOC ANALYSIS OF LONG-TERM EXTENSION STUDIES. Abstract. Presented at: 2025 NASPGHAN Annual Meeting. November 5-9, 2025. Chicago, Illinois.