Effect of liraglutide treatment on jejunostomy output in patients with short bowel syndrome: An open-label pilot study

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Mark Hvistendahl, Christopher Filtenborg Brandt, Siri Tribler, Rahim Mohammad Naimi, Bolette Hartmann, Jens Juul Holst, Jens Frederik Rehfeld, Mads Hornum, Jens Rikardt Andersen, Birthe Merete Henriksen, Per Brøbech Mortensen, Palle Bekker Jeppesen

BACKGROUND: An impaired hormonal "ileo-colonic brake" may contribute to rapid gastric emptying, gastric hypersecretion, high ostomy losses, and the need for parenteral support in end-jejunostomy short bowel syndrome (SBS) patients with intestinal failure (IF). Liraglutide, a glucagon-like peptide 1 receptor agonist, may reduce gastric hypersecretion and dampen gastric emptying, thereby improving conditions for intestinal absorption.

MATERIALS AND METHODS: In an 8-week, open-label pilot study, liraglutide was given subcutaneously once daily to 8 end-jejunostomy patients, aged 63.4 ± 10.9 years (mean ± SD) and with small bowel lengths of 110 ± 66 cm. The 72-hour metabolic balance studies were performed before and at the end of treatment. Food intake was unrestricted. Oral fluid intake and parenteral support volume were kept constant. The primary end point was change in the ostomy wet weight output.

RESULTS: Liraglutide reduced ostomy wet weight output by 474 ± 563 g/d from 3249 ± 1352 to 2775 ± 1187 g/d (P =049, Student t test). Intestinal wet weight absorption tended to increase by 464 ± 557 g/d (P = .05), as did urine production by 765 ± 759 g/d (P =02). Intestinal energy absorption improved by 902 ± 882 kJ/d (P = .02).

CONCLUSION: Liraglutide reduced ostomy wet weight output in end-jejunostomy patients with SBS-IF and increased their intestinal wet weight and energy absorption. If larger, randomized, placebo-controlled studies confirm these effects, it adds to the hypothesis that many ileo-colonic brake hormones in conjunction may be involved in the process of intestinal adaptation. By identification of key hormones and addressing their potential synergistic effects, better treatments may be provided to patients with SBS-IF. This trial was registered at clinicaltrialsregister.eu as 2013-005499-16.

Original languageEnglish
JournalJournal of Parenteral and Enteral Nutrition
Volume42
Issue number1
Pages (from-to)112-121
Number of pages10
ISSN0148-6071
DOIs
Publication statusPublished - 2018

    Research areas

  • The Faculty of Science - Short bowel syndrome, Gastroenterology, Parenteral nutrition, Nutrition, Diarrhea, Research, Disease

ID: 169159206