A potentially life-changing treatment has been recommended for people with short bowel syndrome who are aged one year and above after NICE published final draft guidance.
Teduglutide (also known as Revestive and made by Takeda) is available for people who are in a stable condition following surgery to remove an abnormal bowel. In adults, this surgery may be needed for a range of conditions, including Crohn’s disease. In premature babies and children, it is often because of surgery for necrotising enterocolitis or other conditions. Some children can be born with a short bowel.
Teduglutide helps to improve the absorption of nutrients and fluid from the remaining intestine. The company estimates there are around 70 people eligible for the treatment.
Short bowel syndrome is a chronic and potentially life-threatening condition in which the body is unable to absorb enough nutrients from food. The condition occurs when people do not have enough small intestine, which is the part of the body where most nutrients are absorbed during digestion.
Short bowel syndrome is currently treated by giving people nutrients and fluids intravenously through a drip, also known as parenteral support, alongside best supportive care. Best supportive care can include treatments which control bowel movements, fluid restriction and diet changes.
Clinical trial evidence shows that teduglutide reduces the number of days a week people with short bowel syndrome need parenteral support compared with placebo.
Helen Knight, interim director of medicines evaluation in the NICE Centre for Health Technology Evaluation, said: “Current treatments for short bowel syndrome are lifesaving, but they can be very complex, time consuming and can lead to severe complications. People with short bowel syndrome currently need parenteral support which can be required for as much as 14 hours a day, 7 days a week.
“NICE’s independent appraisal committee heard that people with short bowel syndrome often have very limited quality of life and there is a heavy burden placed on them and their carers by having to administer treatment at home. Clinical evidence showed teduglutide can help give people with short bowel syndrome greater normality by reducing the number of days per week people would require parenteral support. I am therefore delighted we can recommend teduglutide for some people with this condition.”
The recommended daily dose of teduglutide is 0.05 mg per kg body weight. The dose will be given in millilitres (ml) of solution. Teduglutide is injected under the skin (subcutaneously) once daily.