Sitagliptin, a dipeptidyl peptidase-4 inhibitor, in patients with short bowel syndrome and colon in continuity: an open-label pilot study

Research output: Contribution to journalJournal articlepeer-review

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Sitagliptin, a dipeptidyl peptidase-4 inhibitor, in patients with short bowel syndrome and colon in continuity : an open-label pilot study. / Naimi, Rahim Mohammad; Hvistendahl, Mark Krogh; Thomassen, Lise Margrete; Johnsen, Hanna; Christiansen, Charlotte Bayer; Holst, Jens Juul; Hartmann, Bolette; Jeppesen, Palle Bekker.

In: BMJ Open Gastroenterology, Vol. 8, No. 1, e000604, 2021.

Research output: Contribution to journalJournal articlepeer-review

Harvard

Naimi, RM, Hvistendahl, MK, Thomassen, LM, Johnsen, H, Christiansen, CB, Holst, JJ, Hartmann, B & Jeppesen, PB 2021, 'Sitagliptin, a dipeptidyl peptidase-4 inhibitor, in patients with short bowel syndrome and colon in continuity: an open-label pilot study', BMJ Open Gastroenterology, vol. 8, no. 1, e000604. https://doi.org/10.1136/bmjgast-2021-000604

APA

Naimi, R. M., Hvistendahl, M. K., Thomassen, L. M., Johnsen, H., Christiansen, C. B., Holst, J. J., Hartmann, B., & Jeppesen, P. B. (2021). Sitagliptin, a dipeptidyl peptidase-4 inhibitor, in patients with short bowel syndrome and colon in continuity: an open-label pilot study. BMJ Open Gastroenterology, 8(1), [e000604]. https://doi.org/10.1136/bmjgast-2021-000604

Vancouver

Naimi RM, Hvistendahl MK, Thomassen LM, Johnsen H, Christiansen CB, Holst JJ et al. Sitagliptin, a dipeptidyl peptidase-4 inhibitor, in patients with short bowel syndrome and colon in continuity: an open-label pilot study. BMJ Open Gastroenterology. 2021;8(1). e000604. https://doi.org/10.1136/bmjgast-2021-000604

Author

Naimi, Rahim Mohammad ; Hvistendahl, Mark Krogh ; Thomassen, Lise Margrete ; Johnsen, Hanna ; Christiansen, Charlotte Bayer ; Holst, Jens Juul ; Hartmann, Bolette ; Jeppesen, Palle Bekker. / Sitagliptin, a dipeptidyl peptidase-4 inhibitor, in patients with short bowel syndrome and colon in continuity : an open-label pilot study. In: BMJ Open Gastroenterology. 2021 ; Vol. 8, No. 1.

Bibtex

@article{c4d055c88c8643049c739bc6186e5736,
title = "Sitagliptin, a dipeptidyl peptidase-4 inhibitor, in patients with short bowel syndrome and colon in continuity: an open-label pilot study",
abstract = "OBJECTIVE: Patients with short bowel syndrome (SBS) and colon in continuity have better adaptation potential compared with patients with jejunostomy. Adaptation may involve enhanced postprandial secretion of the enteroendocrine hormones glucagon-like peptide (GLP)-1 and GLP-2 which are normally degraded by dipeptidyl peptidase (DPP)-4. Nevertheless, some patients with SBS with colon in continuity suffer from high-volume faecal excretions and have been shown to benefit from treatment with GLP-2. Therefore, we aimed to evaluate efficacy of sitagliptin, a DPP-4 inhibitor, on reducing faecal excretions in this patient group.DESIGN: In an open-label, case series, proof-of-concept pilot study, 100 mg oral sitagliptin was given two times per day for 8 weeks to patients with SBS with ≥50% colon in continuity with or without the need for parenteral support (PS). To assess intestinal function, metabolic balance studies were done at baseline and following 8 weeks of treatment.RESULTS: Of the 10 patients planned for enrolment, 8 patients were included; 7 patients completed the study. Although postprandial endogenous GLP-2 concentrations increased by 49 hours×pmol/L (39, 105; p=0.018) (median (min, max)), sitagliptin did not significantly reduce median faecal wet weight (-174 g/day (-1510, 675; p=0.176)) or increase intestinal wet weight absorption. However, heterogeneity in the treatment effect was observed: intestinal wet weight absorption increased in all four patients with intestinal failure. One patient achieved a reduction in PS by 500 mL per administration day.CONCLUSION: Following this negative, small pilot study, larger, placebo-controlled, studies are needed to establish the therapeutic potential of DPP-4 inhibition in patients with SBS.",
author = "Naimi, {Rahim Mohammad} and Hvistendahl, {Mark Krogh} and Thomassen, {Lise Margrete} and Hanna Johnsen and Christiansen, {Charlotte Bayer} and Holst, {Jens Juul} and Bolette Hartmann and Jeppesen, {Palle Bekker}",
year = "2021",
doi = "10.1136/bmjgast-2021-000604",
language = "English",
volume = "8",
journal = "B M J Open Gastroenterology",
issn = "2054-4774",
publisher = "B M J Group",
number = "1",

}

RIS

TY - JOUR

T1 - Sitagliptin, a dipeptidyl peptidase-4 inhibitor, in patients with short bowel syndrome and colon in continuity

T2 - an open-label pilot study

AU - Naimi, Rahim Mohammad

AU - Hvistendahl, Mark Krogh

AU - Thomassen, Lise Margrete

AU - Johnsen, Hanna

AU - Christiansen, Charlotte Bayer

AU - Holst, Jens Juul

AU - Hartmann, Bolette

AU - Jeppesen, Palle Bekker

PY - 2021

Y1 - 2021

N2 - OBJECTIVE: Patients with short bowel syndrome (SBS) and colon in continuity have better adaptation potential compared with patients with jejunostomy. Adaptation may involve enhanced postprandial secretion of the enteroendocrine hormones glucagon-like peptide (GLP)-1 and GLP-2 which are normally degraded by dipeptidyl peptidase (DPP)-4. Nevertheless, some patients with SBS with colon in continuity suffer from high-volume faecal excretions and have been shown to benefit from treatment with GLP-2. Therefore, we aimed to evaluate efficacy of sitagliptin, a DPP-4 inhibitor, on reducing faecal excretions in this patient group.DESIGN: In an open-label, case series, proof-of-concept pilot study, 100 mg oral sitagliptin was given two times per day for 8 weeks to patients with SBS with ≥50% colon in continuity with or without the need for parenteral support (PS). To assess intestinal function, metabolic balance studies were done at baseline and following 8 weeks of treatment.RESULTS: Of the 10 patients planned for enrolment, 8 patients were included; 7 patients completed the study. Although postprandial endogenous GLP-2 concentrations increased by 49 hours×pmol/L (39, 105; p=0.018) (median (min, max)), sitagliptin did not significantly reduce median faecal wet weight (-174 g/day (-1510, 675; p=0.176)) or increase intestinal wet weight absorption. However, heterogeneity in the treatment effect was observed: intestinal wet weight absorption increased in all four patients with intestinal failure. One patient achieved a reduction in PS by 500 mL per administration day.CONCLUSION: Following this negative, small pilot study, larger, placebo-controlled, studies are needed to establish the therapeutic potential of DPP-4 inhibition in patients with SBS.

AB - OBJECTIVE: Patients with short bowel syndrome (SBS) and colon in continuity have better adaptation potential compared with patients with jejunostomy. Adaptation may involve enhanced postprandial secretion of the enteroendocrine hormones glucagon-like peptide (GLP)-1 and GLP-2 which are normally degraded by dipeptidyl peptidase (DPP)-4. Nevertheless, some patients with SBS with colon in continuity suffer from high-volume faecal excretions and have been shown to benefit from treatment with GLP-2. Therefore, we aimed to evaluate efficacy of sitagliptin, a DPP-4 inhibitor, on reducing faecal excretions in this patient group.DESIGN: In an open-label, case series, proof-of-concept pilot study, 100 mg oral sitagliptin was given two times per day for 8 weeks to patients with SBS with ≥50% colon in continuity with or without the need for parenteral support (PS). To assess intestinal function, metabolic balance studies were done at baseline and following 8 weeks of treatment.RESULTS: Of the 10 patients planned for enrolment, 8 patients were included; 7 patients completed the study. Although postprandial endogenous GLP-2 concentrations increased by 49 hours×pmol/L (39, 105; p=0.018) (median (min, max)), sitagliptin did not significantly reduce median faecal wet weight (-174 g/day (-1510, 675; p=0.176)) or increase intestinal wet weight absorption. However, heterogeneity in the treatment effect was observed: intestinal wet weight absorption increased in all four patients with intestinal failure. One patient achieved a reduction in PS by 500 mL per administration day.CONCLUSION: Following this negative, small pilot study, larger, placebo-controlled, studies are needed to establish the therapeutic potential of DPP-4 inhibition in patients with SBS.

U2 - 10.1136/bmjgast-2021-000604

DO - 10.1136/bmjgast-2021-000604

M3 - Journal article

C2 - 33975891

VL - 8

JO - B M J Open Gastroenterology

JF - B M J Open Gastroenterology

SN - 2054-4774

IS - 1

M1 - e000604

ER -

ID: 262899849