Development of a consensus parenteral solution weaning algorithm for children with short-bowel syndrome associated intestinal failure responding to teduglutide therapy

Background Teduglutide is a glucagon-like peptide 2 analogue with demonstrated efficacy in reducing parenteral solution (PS) requirements to facilitate enteral autonomy in children with short bowel syndrome-associated intestinal failure (SBS-IF). There is currently no clear consensus on how to wean PS and monitor children once treatment is commenced, with variable regimens utilised in published paediatric and adult studies. We aimed to develop a practical algorithm for PS weaning in children with SBS-IF responding to teduglutide for use in the real-world setting.Methods A modified Delphi approach was adopted to achieve consensus with input from a multidisciplinary group of paediatric clinicians with intestinal rehabilitation expertise.Results We describe the resulting PS-weaning algorithm, which is easy to use, pragmatic and paediatric focused.Conclusion Future studies will be required to validate the algorithm.