Teduglutide

approved

Also known as: Gattex, Revestive, GLP-2 analog

Teduglutide is a recombinant analog of glucagon-like peptide-2 (GLP-2) that acts as a selective GLP-2 receptor agonist. Its primary mechanism involves binding to GLP-2 receptors in the gastrointestinal tract, which stimulates crypt cell proliferation and reduces enterocyte apoptosis, leading to increased intestinal mucosal growth, enhanced absorptive surface area, and improved nutrient and fluid absorption. Additionally, teduglutide slows gastric emptying and reduces intestinal motility, further supporting its therapeutic effects in conditions of intestinal failure. Key research findings from clinical trials demonstrate that teduglutide significantly reduces parenteral nutrition (PN) requirements in patients with short bowel syndrome (SBS). In pivotal Phase III studies (e.g., STEPS trial), approximately 63% of teduglutide-treated patients achieved a ≥20% reduction in weekly PN volume compared to placebo, with some achieving complete independence from PN. Long-term extension studies confirm sustained efficacy and safety over up to 2 years, with common adverse events including abdominal pain, nausea, and injection-site reactions. Mechanistic studies also suggest potential benefits in intestinal adaptation and barrier function. Clinically, teduglutide is approved (e.g., FDA, EMA) for adult and pediatric patients with SBS who are dependent on PN. It is administered subcutaneously once daily and requires monitoring for potential risks such as gastrointestinal obstruction, gallbladder disease, and pancreatic or biliary tract neoplasia. Its use is limited to specialized centers due to the need for careful patient selection and follow-up. Teduglutide represents a targeted therapy that addresses the underlying pathophysiology of SBS by promoting intestinal adaptation and reducing PN dependence. For research purposes only — not medical advice.

Key data

Category
Gut & GI
Molecular weight
3752.1 g/mol
Molecular formula
C164H252N44O55S
CAS number
197922-42-2
Administration
subcutaneous
Research status
approved
References
353
Tags
glp-2, approved, intestinal-growth

Research & studies

Teduglutide
2025 · PubMed
Teduglutide for treatment-refractory severe intestinal acute graft-versus-host disease - a multicenter survey
Bone marrow transplantation · 2025 · PubMed

Best response (CR or PR) was 64.7% (11/17) including 41.2% CR and 23.5% PR.; At median follow-up of 28 weeks, 10/17 patients were alive.; Most patients had increased albumin levels within 2 months, even among non-responders.; No specific teduglutide-related toxicity was reported.

European Consensus on Malabsorption-UEG & SIGE, LGA, SPG, SRGH, CGS, ESPCG, EAGEN, ESPEN, and ESPGHAN: Part 2: Screening, Special Populations, Nutritional Goals, Supportive Care, Primary Care Perspective
United European gastroenterology journal · 2025 · PubMed

Coeliac disease should always be investigated in unexplained malabsorption and high-risk individuals due to its high prevalence.; Teduglutide effectively reduces the need for parenteral nutrition in short bowel syndrome, improving quality of life.; Primary care physicians are crucial for early detection and should be part of multidisciplinary teams.; Nutritional support options include oral supplements, enteral nutrition, and parenteral nutrition.

European Consensus on Malabsorption-UEG & SIGE, LGA, SPG, SRGH, CGS, ESPCG, EAGEN, ESPEN, and ESPGHAN. Part 1: Definitions, Clinical Phenotypes, and Diagnostic Testing for Malabsorption
United European gastroenterology journal · 2025 · PubMed

Malabsorption can be selective or global, caused by congenital or acquired disorders in children and adults.; Early recognition is key, using endoscopy with small intestinal biopsies, non-invasive functional tests, and radiological imaging.; Celiac disease should always be investigated in unexplained malabsorption and high-risk individuals.; Nutritional support (oral, enteral, parenteral) is central; teduglutide reduces parenteral nutrition need in short bowel syndrome.

Updates in Intestinal Failure Management
Journal of clinical medicine · 2025 · PubMed

Nutritional rehabilitation is the cornerstone of IF management, with individualized enteral and parenteral nutrition therapy.; Teduglutide promotes mucosal growth and is used medically, but its oral absorption is poor and milk levels are likely very low.; Two breastfed infants had no reported adverse effects during maternal teduglutide use, but long-term data are lacking.; An interdisciplinary team approach is crucial for managing complex IF patients.

GLP-2 prevents antipsychotics-induced metabolic dysfunction in mice
Nature metabolism · 2025 · PubMed

Teduglutide prevents olanzapine-induced hypothermia and weight gain in mice.; Teduglutide restores glucose tolerance and insulin sensitivity in mice treated with olanzapine.; Olanzapine suppresses VMH Pdyn neurons via serotonin receptor 2C, while teduglutide activates them.; Chemogenetic activation of VMH Pdyn neurons abolishes olanzapine-induced hypothermia and weight gain without affecting psychotropic effects.

Use of glucagon-like polypeptide 2 analogs for intestinal failure
Expert opinion on pharmacotherapy · 2024 · PubMed

GLP-2 has potent intestinotrophic properties improving fluid and electrolyte balance in experimental animals and humans.; A glycine-for-alanine substitution at the second N-terminal position extended GLP-2's half-life to 2.5 hours, allowing single daily subcutaneous injections.; Ultralong-acting GLP-2 analogs with half-lives of 70-80 hours require injections only every three to seven days.; Future research may explore the complementary roles of GLP-1 and GLP-2 in treating short bowel syndrome.

Long-term teduglutide associated with improved response in pediatric short bowel syndrome-associated intestinal failure
Journal of pediatric gastroenterology and nutrition · 2024 · PubMed

Frequently asked questions

What is Teduglutide?

Teduglutide is a recombinant analog of glucagon-like peptide-2 (GLP-2) that acts as a selective GLP-2 receptor agonist. Its primary mechanism involves binding to GLP-2 receptors in the gastrointestinal tract, which stimulates crypt cell proliferation and reduces enterocyte apoptosis, leading to increased intestinal muc

How does Teduglutide work?

GLP-2 receptor agonist that promotes intestinal mucosal growth and absorption; approved for short bowel syndrome.

What is the research status of Teduglutide?

Teduglutide is currently classified as approved, with 353 research references on record. This is for research purposes only and is not medical advice.

What is the molecular weight of Teduglutide?

Teduglutide has a molecular weight of approximately 3752.1 g/mol (formula C164H252N44O55S).

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