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Teduglutide

GLP-2 receptor agonist

Also known as GLP-2 analogue, Gattex, Revestive

A GLP-2 analogue approved for short bowel syndrome. A useful example of a peptide with a narrow, well-defined indication and a correspondingly narrow evidence base.

Guide updated Sep 2, 2026Literature checked Sep 2, 20262 curated studies47 literature recordsBaseline editorial
SequenceHGDGSFSDEMNTILDNLAARDFINWLIQTKITD

Overview

In shortA copy of a gut hormone that makes the small intestine grow. It is approved for one narrow thing: adults and children with short bowel syndrome who depend on IV feeding. That narrowness is why it is here. It shows what a peptide with real, specific evidence actually looks like.

Teduglutide is a 33-amino-acid analogue of glucagon-like peptide-2, modified at position 2 to resist DPP-4 degradation. Where GLP-1 is a metabolic signal, GLP-2 is an intestinotrophic one: it drives mucosal growth in the small intestine.

It is approved for adults and children with short bowel syndrome who are dependent on parenteral support. That narrowness is the point of including it here. It is a peptide with a real, specific, well-characterised indication, and looks nothing like the broad claims often attached to compounds with far weaker evidence.

Mechanism

In shortThis hormone tells the gut lining to grow. It does not act on the lining directly; it works through nerves and support cells next to it. The result is a larger absorbing surface and more blood flow, so the bowel a person has left takes up more fluid and nutrients.

GLP-2 is secreted by intestinal L-cells alongside GLP-1. It acts through the GLP-2 receptor, expressed on enteric neurons, subepithelial myofibroblasts, and enteroendocrine cells rather than directly on enterocytes, so the trophic effect is mediated indirectly.

The consequences are increased villus height and crypt depth, increased mucosal surface area, increased intestinal blood flow, and reduced gastric emptying and secretion. The net effect in short bowel syndrome is improved fluid and nutrient absorption from the remaining bowel.

Evidence

In shortGood for the one thing it is approved for, and essentially nothing outside it. In the main trial, significantly more people cut their weekly IV feeding by a fifth or more than on placebo, and follow-up suggests that holds, with some coming off IV feeding entirely. The trials are small because the condition is rare, so rare side effects are poorly mapped.

Adequate for its narrow approved indication and essentially absent for anything else.

The pivotal STEPS trial reported that a significantly greater proportion of teduglutide-treated patients achieved a 20 to 100% reduction in weekly parenteral support volume versus placebo. Extension studies report that reductions are maintained and that some patients achieve independence from parenteral support.

Trials are small by the standards of the entries above, because the population is small. That is a legitimate constraint rather than a methodological failure, but it does mean rare adverse events are poorly characterised.

Safety

In shortCommon: stomach pain and bloating, nausea, injection site reactions. The concern that matters most is that the same growth signal which repairs gut lining could speed up a cancer that is already there, which is why a colonoscopy before starting and repeat checks during treatment are on the label.

Common effects are abdominal pain and distension, nausea, injection site reactions, and stoma complications where relevant.

The mechanistically important concern is that the same trophic signalling that regenerates mucosa could accelerate growth of existing neoplasia. Colonoscopy before initiating and periodically during treatment is part of the labelling for that reason. Cases of intestinal obstruction, biliary and pancreatic disease have been reported.

Specialist-supervised therapy in a medically complex population.

Regulatory status

In shortApproved in the US, the EU and elsewhere for short bowel syndrome in people dependent on IV feeding, with rare-disease status in several regions. Not approved for any general gut health or metabolic use.

Approved in the United States, the European Union, and several other jurisdictions for short bowel syndrome with parenteral support dependence. Orphan designation in multiple regions. Not available or approved for any general metabolic or gut-health indication.

The literature

2 studies indexed. Findings and limitations get equal weight, on purpose.

Always check the primary source

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Everything above is free to read. What an account opens is the evidence underneath it: 2 studies with their limitations, and the regimen each trial actually reported.

  • Every study, with what it found and what it cannot show
  • The limitations, given the same weight as the findings
  • The dose each named trial administered, where recorded
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The wider literature

17 indexed papers and 30 registered trials mentioning Teduglutide, straight from PubMed and ClinicalTrials.gov. 27 of 30 administer it; the rest measure it. These have not been read by us. Unlike the studies above, they carry no findings and no limitations written by anyone here, because writing either would mean claiming a reading nobody has done. They are a starting point for yours.

Registered trials (30)

  1. Glucagon-like Peptide 2 (GLP-2) in Undernourished Women Improving From Histology-Confirmed Environmental Enteric Dysfunction (EED)

    International Centre for Diarrhoeal Disease Research, Bangladesh2026NCT07537686

    interventionalphase2not yet recruitingn=55

  2. Efficacy and Safety of PJ009 in Patients With Short Bowel Syndrome Requiring Parenteral Nutrition

    Chongqing Peg-Bio Biopharm Co., Ltd.2024NCT06512584

    interventionalphase3recruitingn=72

  3. TED_ORG: Study on Short Bowel Syndrome

    Meyer Children's Hospital IRCCS2024NCT07400783

    interventionalnarecruitingn=50

  4. A Study of Teduglutide (Revestive®) in Participants With Short Bowel Syndrome (SBS) in Canada

    Takeda2023NCT05371028

    observationalcompletedn=52

  5. A Study of Teduglutide in Japanese Children With Short Bowel Syndrome Aged 4 Months or Older

    Takeda2022NCT05027308

    interventionalphase3completedn=3

  6. A Study With Teduglutide (Revestive®) in Adults With Short Bowl Syndrome

    Takeda2022NCT04883606

    observationalcompletedn=65

  7. Pilot Study to Investigate the Effect of Teduglutide on Temporary Ileostomy Function and Complications

    Allegheny Singer Research Institute (also known as Allegheny Health Network Research Institute)2022NCT03953170

    interventionalphase3withdrawnn=0

  8. Quality of Life in Patients With Short Bowel Syndrome Treated Without and With Teduglutide - a Prospective Nested Matched Pair Analysis

    Charite University, Berlin, Germany2020NCT04733066

    observationalunknownn=40

  9. Therapeutic Approaches to Malnutrition Enteropathy

    Queen Mary University of London2020NCT03716115

    interventionalphase2completedn=125

  10. Glucagon-like Peptide-2 Mediated Secretion of Stored Enteral Lipids

    University Health Network, Toronto2019NCT03442972

    interventionalphase2phase3completedn=21

  11. Effects of Oral Glucose and Teduglutide on Plasma Lipoproteins

    University Health Network, Toronto2019NCT03860688

    interventionalphase2phase3unknownn=15

  12. Teduglutide for Enterocutaneous Fistula (ECF)

    Daniel Dante Yeh2019NCT02889393

    interventionalphase2completedn=6

  13. Characterization of the Long-term Safety, Efficacy, and Pharmacodynamics Revestive® in the Management of Short Bowel Syndrome Pediatric Patients

    Assistance Publique - Hôpitaux de Paris2018NCT03562130

    interventionalphase4completedn=25

  14. Study of Teduglutide in Japanese Participants With Short Bowel Syndrome

    Shire2018NCT03663582

    interventionalphase3completedn=7

  15. Safety, Efficacy, PD of FE203799 in Short Bowel Syndrome on Parenteral Support

    GlyPharma Therapeutics2018NCT03415594

    interventionalphase1phase2completedn=8

  16. Plasma Lipoprotein Response to Glucagon-like Peptide-2

    University Health Network, Toronto2018NCT03422666

    interventionalphase2phase3completedn=10

  17. Safety, Efficacy and Pharmacokinetic Study of Teduglutide in Infants 4 to 12 Months of Age With Short Bowel Syndrome

    Shire2018NCT03571516

    interventionalphase3completedn=10

  18. Treatment of Patients With Teduglutide (GLP-2) for GVHD and Analysis of Paneth Cells of GVHD Patients

    University of Freiburg2017NCT04290429

    interventionalearly_phase1completedn=6

  19. A Study in Japanese Children With Short Bowel Syndrome Who Completed SHP633-302

    Shire2017NCT03268811

    interventionalphase3completedn=9

  20. Teduglutide in Short Bowel Syndrome Patients

    Medical University of Vienna2016NCT04857801

    observationalcompletedn=17

  21. A Study of the Gut Barrier and Blood Vessel Inflammation in Individuals With and Without HIV

    Massachusetts General Hospital2015NCT02431325

    interventionalphase2completedn=32

  22. Study to Evaluate the Safety, Efficacy and Pharmacokinetics of Teduglutide in Japanese Subjects With PN-dependent Short Bowel Syndrome (SBS)

    Shire2014NCT02340819

    interventionalphase3completedn=11

  23. A One-Year, Open-Label Study With Teduglutide for Subjects Who Completed Study CL0600-021

    Shire2012NCT01560403

    interventionalphase3completedn=14

  24. Effect of Teduglutide on Gastric Emptying in Healthy Subjects

    Shire2010NCT01209351

    interventionalphase1completedn=36

  25. Effects of Teduglutide on Cardiac Repolarisation and Conduction in Healthy Male and Female Volunteers

    Nycomed2009NCT01028924

    interventionalphase1completedn=72

  26. Open-Label Study of Teduglutide for Subjects With PN-Dependent Short Bowel Syndrome (SBS)

    Shire2009NCT00930644

    interventionalphase3completedn=88

  27. Pharmacokinetics (PK) of 20 mg Teduglutide in Participants With Moderately Impaired Hepatic Function Compared to Healthy Participants

    Shire2007NCT00819468

    interventionalphase1completedn=24

  28. A Double-Blind Multi-Dose Tolerability and Pharmacokinetic Study of Teduglutide

    Shire2006NCT00820885

    interventionalphase1completedn=95

  29. Safety and Efficacy Study of Teduglutide in Subjects With Short Bowel Syndrome Who Completed Protocol CL0600-004 (NCT00081458)

    Shire2005NCT00172185

    interventionalphase3completedn=65

  30. Safety and Efficacy of ALX-0600 in Subjects With Active Crohn's Disease Who Completed Protocol CL0600-008

    Shire2004NCT00308438

    interventionalphase2completedn=67

Papers (17)

  1. 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.

    Lenti MV, et al.United European gastroenterology journal2025PMID 40129317

    consensus statementjournal articlepractice guidelineresearch support, non-u.s. gov't

  2. GLP-2 prevents antipsychotics-induced metabolic dysfunction in mice.

    Peng Y, et al.Nature metabolism2025PMID 40114026

    journal article

  3. 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.

    Lenti MV, et al.United European gastroenterology journal2025PMID 40088199

    consensus statementjournal articleresearch support, non-u.s. gov't

  4. Updates in Intestinal Failure Management.

    Wang SZ, et al.Journal of clinical medicine2025PMID 40364063

    journal articlereview

  5. Teduglutide for the treatment of short bowel syndrome: a double-edged sword?

    Oliveira SB, et al.The American journal of clinical nutrition2023PMID 37270286

    editorialcomment

  6. Definition, classification, and causes of short bowel syndrome.

    Pironi LNutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition2023PMID 37115031

    journal articlereview

  7. Understanding short bowel syndrome: Current status and future perspectives.

    Massironi S, et al.Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver2020PMID 31892505

    journal articlereview

  8. Treating short bowel syndrome with pharmacotherapy.

    Hollanda Martins Da Rocha M, et al.Expert opinion on pharmacotherapy2020PMID 32057270

    journal articlereview

  9. Emerging treatments for short bowel syndrome in adult patients.

    Billiauws L, et al.Expert review of gastroenterology & hepatology2019PMID 30791759

    journal articlereview

  10. Practical management of home parenteral nutrition in infancy.

    Hill SEarly human development2019PMID 31606228

    journal articlereview

  11. Weaning from Parenteral Nutrition.

    Ukleja AGastroenterology clinics of North America2019PMID 31668181

    journal articlereview

  12. Teduglutida: revisión de su uso en el síndrome de intestino corto.

    Burgos Peláez R, et al.Nutricion hospitalaria2016PMID 27571675

    journal articlereview

  13. Intestinal adaptation following resection.

    Tappenden KAJPEN. Journal of parenteral and enteral nutrition2014PMID 24586019

    journal articleresearch support, non-u.s. gov'treview

  14. Teriflunomide.

    Cada DJ, et al.Hospital pharmacy2013PMID 24421467

    journal article

  15. Gateways to clinical trials.

    Tomillero A, et al.Methods and findings in experimental and clinical pharmacology2009PMID 19455266

    bibliographyjournal article

  16. Gateways to clinical trials.

    Bayés M, et al.Methods and findings in experimental and clinical pharmacology2007PMID 18193114

    bibliographyjournal article

  17. Teduglutide.

    2006PMID 36701512

    review

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For Research & Educational Discussion Only. Not Medical Advice

This guide is educational reference material compiled from published literature. It is not medical advice, not a recommendation, and not a substitute for a clinician who knows your history. Nothing here should be used to make a decision about your own health without one.

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