Teduglutide Explained

Watchedfields:changed
Verifiedrevid:443663022
Tradename:Revestive, Gattex
Dailymedid:Teduglutide
Routes Of Administration:Subcutaneous injection
Atc Prefix:A16
Atc Suffix:AX08
Legal Au:S4
Legal Au Comment:[1] [2]
Legal Ca:Rx-only
Legal Ca Comment:[3]
Legal Us:Rx-only
Legal Eu:Rx-only
Bioavailability:88%
Metabolism:Proteolysis
Elimination Half-Life:2h
Cas Number:197922-42-2
Pubchem:16139605
Iuphar Ligand:7049
Chemspiderid:17296109
Unii:7M19191IKG
Kegg:D06053
Chebi:72305
Iupac Name:L-histidylglycyl-L-α-aspartylglycyl-L-seryl-L-phenylalanyl-L-seryl-L-α-aspartyl-L-α-glutamyl-L-methionyl-L-asparaginyl-L-threonyl-L-isoleucyl-L-leucyl-L-α-aspartyl-L-asparaginyl-L-leucyl-L-alanyl-L-alanyl-L-arginyl-L-α-aspartyl-L-phenylalanyl-L-isoleucyl-L-asparaginyl-L-tryptophyl-L-leucyl-L-isoleucyl-L-glutaminyl-L-threonyl-L-lysyl-L-isoleucyl-L-threonyl-L-aspartic acid
C:164
H:252
N:44
O:55
S:1
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Stdinchikey:CILIXQOJUNDIDU-ASQIGDHWSA-N

Teduglutide, sold under the brand names Revestive (EU) and Gattex (US), is a 33-membered polypeptide and glucagon-like peptide-2 (GLP-2) analog that is used for the treatment of short bowel syndrome. It works by promoting mucosal growth and possibly restoring gastric emptying and secretion.[4] It was approved in both the European Union[5] and the United States in 2012.[6]

Medical uses

Up to a certain point, the gut can adapt to partial resections that result in short bowel syndrome. Still, parenteral substitution of water, minerals and vitamins (depending on which part of the gut has been removed) is often necessary. Teduglutide may reduce or shorten the necessity of such infusions by improving the intestinal mucosa and possibly by other mechanisms.[7]

Adverse effects

Common adverse effects in clinical studies included abdominal discomfort (49% of patients), respiratory infections (28%), nausea (27%) and vomiting (14%), local reactions at the injection site (21%), and headache (17%).

Chemistry and mechanism of action

Teduglutide differs from natural GLP-2 by a single amino acid: an alanine is replaced with a glycine. This blocks breaking down of the molecule by dipeptidyl peptidase and increases its half-life from seven minutes (GLP-2) to about two hours, while retaining its biological actions. These include maintenance of the intestinal mucosa, increasing intestinal blood flow, reducing gastrointestinal motility and secretion of gastric acid.

Society and culture

Legal status

It was approved in both the European Union (brand name Revestive)[8] and the United States (brand name Gattex) in 2012. It was granted orphan drug designation by the European Medicines Agency (EMA).

Notes and References

  1. Web site: Prescription medicines: registration of new chemical entities in Australia, 2017 . Therapeutic Goods Administration (TGA) . 21 June 2022 . 9 April 2023.
  2. Web site: Prescription medicines and biologicals: TGA annual summary 2017 . Therapeutic Goods Administration (TGA) . 21 June 2022 . 31 March 2024.
  3. Web site: Health Canada New Drug Authorizations: 2015 Highlights . . 4 May 2016 . 7 April 2024.
  4. Jeppesen PB . Teduglutide, a novel glucagon-like peptide 2 analog, in the treatment of patients with short bowel syndrome . Therapeutic Advances in Gastroenterology . 5 . 3 . 159–71 . May 2012 . 22570676 . 3342570 . 10.1177/1756283X11436318 .
  5. Web site: Revestive EPAR . European Medicines Agency (EMA) . 11 December 2001 . 20 March 2024.
  6. Web site: Gattex- teduglutide injection, powder, lyophilized, for solution; Gattex- teduglutide kit . DailyMed . 28 February 2024 . 20 March 2024.
  7. Klement A . 5 January 2015. Das Kurzdarmsyndrom ist erstmals behandelbar: Revestive. Österreichische Apothekerzeitung. 1/2015. 20f. German.
  8. Web site: Revestive Product information . Union Register of medicinal products . 4 September 2012 . 20 March 2024.