Teduglutide: what the evidence shows

What the human research shows

A peptide that solved a problem nothing else solves: reducing dependence on intravenous nutrition in a rare, severe condition. Grade A on a randomised placebo-controlled phase 3 with a hard, patient-relevant endpoint, and a real oncological caution attached.

Evidence profile0–5

Metabolic & weight—0.0
Cardiovascular—0.0
Muscle & growth—0.0
Healing & repair—0.0
Neuro & sleep—0.0
Immune & inflammation—0.0
Sexual & hormonal—0.0
Skin & appearance—0.0
Ageing & longevity—0.0

No benefit outcome for Teduglutide has both human evidence and a measurable effect, so the profile is empty. That is the finding, not a gap in the chart.

Outcome	Grade	Effect size	Human studies	Where the evidence comes from
Reduced parenteral support in short bowel syndrome	AEstablished	Moderate	1 phase 3 RCT (STEPS, n=86, 24 wk)	STEPS randomised 86 adults dependent on parenteral support to daily teduglutide or placebo. The response endpoint — a 20–100% reduction in weekly parenteral volume at weeks 20 and 24 — was reached by 63% against 30% on placebo.1
Days free of intravenous feeding	AEstablished	Moderate	1 phase 3 RCT (STEPS, n=86, 24 wk)	The outcome patients feel: more than half of treated patients gained at least one night a week off parenteral support, against under a quarter on placebo.1
Colorectal neoplasia riskadverse	AEstablished	Small	Label; approval programme	Because teduglutide is trophic to intestinal mucosa, the Gattex label requires colonoscopy before starting and at intervals thereafter, and lists colorectal polyps and the theoretical risk of neoplasia. An intended mechanism that is also the main long-term caution.2
Gastrointestinal and stoma adverse effectsadverse	AEstablished	Moderate	Approval programme	Abdominal pain and distension, nausea, stoma complications and fluid overload are the common adverse effects in the label — the predictable consequences of making remaining bowel absorb more.2

AMultiple good human trials, consistentBSome human trials, mostly consistentCFew or weak human studiesDAnimal or anecdotal onlyeffect size · red = adverse

Literature searched to 29 October 2026. Human studies only; animal and cell work informs the mechanism section and nothing else.

Registered trials

ClinicalTrials.gov lists 36 interventional studies naming Teduglutide as an intervention — 32 completed, 1 recruiting, and 19 with results posted to the registry.

A registration is not a result. Anyone can register a study, and many never report — so this list shows what has been attempted, not what has been shown. The graded evidence above is the answer to whether something works.

Study	Phase	Status	Participants	Sponsor	Results
Short Bowel Syndrome and Teduglutide Versus PlaceboNCT02099084 · started Jan 2014	Phase 4	Completed	8	Mayo Clinic	Posted
Open-Label Study of Teduglutide for Subjects With PN-Dependent Short Bowel Syndrome (SBS)NCT00930644 · started Sept 2009	Phase 3	Completed	88	Shire	Posted
Study of Teduglutide Effectiveness in Parenteral Nutrition (PN)-Dependent Short Bowel Syndrome (SBS) SubjectsNCT00798967 · started Nov 2008	Phase 3	Completed	86	Shire	Posted
Safety and Efficacy Study of Teduglutide in Subjects With Short Bowel SyndromeNCT00081458 · started May 2004	Phase 3	Completed	84	Shire	Posted
Safety and Efficacy Study of Teduglutide in Subjects With Short Bowel Syndrome Who Completed Protocol CL0600-004 (NCT00081458)NCT00172185 · started Jan 2005	Phase 3	Completed	65	Shire	Posted
Short Bowel Syndrome Research Study for Children Up To 17 Years of Age on Parenteral NutritionNCT02682381 · started Jun 2016	Phase 3	Completed	59	Shire	Posted
A Pharmacokinetic, Safety, and Pharmacodynamic Study of Teduglutide in Pediatric Subjects With Short Bowel SyndromeNCT01952080 · started Nov 2013	Phase 3	Completed	42	Shire	Posted
Long-term Study of Teduglutide in Pediatric Subjects With Short Bowel Syndrome Who Completed the TED-C13-003 StudyNCT02949362 · started Dec 2016	Phase 3	Completed	29	Shire	Posted

28 further studies are registered. Participant counts marked * are the sponsor's estimate, not a final enrolment. Source: ClinicalTrials.gov, read directly from the registry and refreshed weekly.

What it is

GLP-2 is released by intestinal L-cells and makes remaining bowel grow and absorb more; it is destroyed in minutes by DPP-4. Teduglutide replaces the alanine at position two with glycine, which resists that enzyme and extends the terminal half-life to roughly two hours — enough for daily dosing. The Gattex label describes it as a 33-amino-acid peptide with a molecular weight of 3752.

Short bowel syndrome is rare and its treatment is parenteral nutrition, with the line infections, liver disease and daily burden that come with it. Teduglutide is the only approved drug that reduces how much of it people need, which is why it is on this site: a peptide that changed a standard of care.

How it is thought to work

GLP-2 receptor activation increases villus height and crypt depth, slows transit and raises mesenteric blood flow, so a shortened intestine absorbs more fluid and nutrients. Everything useful and everything concerning about the drug comes from the same action: a trophic signal to intestinal mucosa, which is why the label requires colonoscopic surveillance.

What is still unknown

Long-term neoplasia risk over decades of use; the surveillance requirement exists because the question is open.
Whether benefit is sustained indefinitely or wanes, and what happens on stopping.
Whether the GLP-2 pathway helps in commoner intestinal conditions; the randomised evidence is in short bowel syndrome.

The molecule and how long it lasts

Identity

Formula: C164H252N44O55S
Molecular weight: 3752.1 g/mol
CAS number: 197922-42-2
PubChem: CID 16139605
Sequence: HGDGSFSDEMNTILDNLAARDFINWLIQTKITD

PubChem record, read 29 October 2026; the sequence was derived from that record's own structure and checked against the product label where one exists.

Pharmacokinetics

Route: Subcutaneous injection, once daily
Half-life: About 2 hours in healthy subjects and about 1.3 hours in short bowel syndrome
Licensed regimen (Gattex): 0.05 mg/kg once daily

From the approved product's prescribing information: Gattex prescribing information (DailyMed) The regimen is the label's own wording, reproduced as a regulatory fact.

Regulatory status

European Union

Approved, prescription-only

Revestive authorised centrally since 2012 for short bowel syndrome in adults and children aged 4 months and above.

United States

Approved, prescription-only

Gattex approved in 2012 for adults and, since 2019, children aged 1 year and above dependent on parenteral support.

United Kingdom

Licensed, prescription-only

Revestive licensed by the MHRA.

Australia

Registered, Schedule 4

Revestive registered on the ARTG.

Canada

Authorised, prescription-only

Revestive authorised with a Drug Identification Number.

Sport (WADA)

Not prohibited

GLP-2 analogues are not named on the Prohibited List.

Questions people actually ask

What does teduglutide do?

It makes the remaining small intestine absorb more, so people with short bowel syndrome need less intravenous nutrition. In the pivotal trial 63% reduced their parenteral volume against 30% on placebo, and more than half gained at least one night a week off the drip.

Why does the label require colonoscopy?

Because the drug's mechanism is to make intestinal mucosa grow. The same trophic signal creates a theoretical risk of colorectal neoplasia, so surveillance is built into the label.

Is teduglutide related to the GLP-1 obesity drugs?

Only distantly — both come from the same proglucagon precursor, but GLP-2 acts on the intestinal lining rather than on appetite and insulin. Teduglutide does not cause weight loss; it increases absorption.

One page per claimed effect

ADoes Teduglutide help with reduced parenteral support in short bowel syndrome?1 phase 3 RCT (STEPS, n=86, 24 wk)
ADoes Teduglutide help with days free of intravenous feeding?1 phase 3 RCT (STEPS, n=86, 24 wk)
AHow common is colorectal neoplasia risk with Teduglutide?Label; approval programme
AHow common is gastrointestinal and stoma adverse effects with Teduglutide?Approval programme

References

1
Jeppesen PB, Pertkiewicz M, Messing B, et al. Teduglutide reduces need for parenteral support among patients with short bowel syndrome with intestinal failure (STEPS).Gastroenterology, 2012;143:1473–148186 randomised, 24 weeks. NCT00798967.
2
Gattex (teduglutide) prescribing information.DailyMed, read 29 Oct 2026Route, half-life, licensed regimen, colonoscopy requirement, and the 33-amino-acid structure.
3
PubChem compound record: teduglutide.PubChem, read 29 Oct 2026Formula, molecular weight, CAS and the sequence used on this page.

Change log

2026-10-29Initial publication. Grade A on STEPS and the approval programme.