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Identifying and Treating Patients With SBS-IF

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Presentation on theme: "Identifying and Treating Patients With SBS-IF"— Presentation transcript:

1 Identifying and Treating Patients With SBS-IF

2 Nutritional Homeostasis and Imbalance

3 Normal

4 Imbalance

5 Homeostasis by PS

6 A Spectrum of Intestinal Function and Metabolic Consequences

7 ESPEN Guidelines on Chronic IF in Adults

8 Definitions: Intestinal Insufficiency and IF

9 Pathophysiological Causes of IF

10 What Is SBS-IF?

11 What Is SBS?

12 Alternative Methods of Classification and Characterization of SBS

13 Causes and Preexisting Disease Leading to SBS

14 SBS Classification According to Postsurgical Outcome

15 SBS Classification According to Anatomy Groups

16 SBS Classification According to Remnant Intestinal Absorptive Capacity

17 Absorption of Wet Weight and Energy in Patients Receiving HPN

18 Summary

19 Management of Patients With SBS-IF

20 Consequences of Untreated IF

21 Oversight of Management Strategy and Multidisciplinary Teams in Intestinal Rehabilitation

22 Management Focus: Individualized High Quality of Care to Ensure Best Quality of Life

23 Summary

24 Nonsurgical Treatment of SBS-IF

25 Pharmacologic Treatment of SBS-IF: Objectives

26 Pharmacologic Treatment of SBS-IF: Goal

27 SBS-IF: Most Common Medical Strategies -- Make the Most of What the Patient Still Has

28 ESPEN: Recommendations Regarding Diet

29 ESPEN: Recommendations Regarding Oral Fluid

30 SBS-IF: Most Common Medical Strategies -- Make the Most of What the Patient Still Has (cont)

31 ESPEN: Recommendations Regarding Antidiarrheal Agents

32 ESPEN: Recommendations Regarding Antisecretory Agents

33 SBS-IF: Most Common Medical Strategies -- Make the Most of What the Patient Still Has (cont)

34 SBS Pathophysiology

35 ESPEN: Recommendations Regarding Hormonal Agents

36 ESPEN: Recommendations Regarding Hormonal Agents (cont)

37 Evidence for the Use of Teduglutide

38 Release Sites of Humoral and Neural Mediators of Nutrient Processing

39 Teduglutide

40 Beneficial Effects of Teduglutide

41 STEPS, STEPS-2, and STEPS-3: Study Design

42 STEPS: Patient Demographics

43 STEPS: Primary Endpoint -- Greater Than 20% Reduction in PN/IV

44 STEPS: Mean Reduction in PN/IV Volume at Week 24

45 STEPS: Difference in Mean FCE and Components of FCE at Week 24

46 STEPS: Patients Achieving at Least 1 Day off PN per Week

47 STEPS and STEPS-2: PN/IV Volume Reductions Over 30 Months

48 Teduglutide: Safety/Tolerability

49 Benefits of Intestinal Rehabilitation

50 Program Summary

51 Program Summary (cont)

52 Abbreviations

53 Abbreviations (cont)


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