GLP-2 Agonists for Short Bowel Syndrome: A Comprehensive Side Effect Review

Patients with Short Bowel Syndrome (SBS), a severe malabsorptive disorder often requiring parenteral nutrition (PN), face significant morbidity. Glucagon-like peptide-2 (GLP-2) agonists have emerged as a vital therapy, promoting intestinal adaptation and reducing PN dependence. However, a thorough understanding of the side effect profile and long-term safety of GLP-2 agonists in the SBS population is essential for optimal clinical management.

The review highlighted that while GLP-2 agonists significantly improve intestinal function in SBS patients, their use is associated with a distinct set of side effects. Analysis of pooled data indicated that abdominal pain was reported in approximately 30-40% of patients, often mild to moderate. Nausea and vomiting occurred in 20-25% and 15-20% respectively, particularly during the initial treatment phase. > The most significant finding was the consistent observation of fluid retention and peripheral edema in 25-35% of patients, sometimes requiring diuretic intervention, and a 2-fold increased risk of cholelithiasis (gallstones) compared to placebo groups (p<0.05). Furthermore, a 1.5-fold higher incidence of intestinal obstruction was noted in treated patients (p<0.01), though often transient. The review also discussed the potential for pancreatitis (inflammation of the pancreas) (reported in <1% of patients) and the need for vigilance regarding neoplastic changes due to the trophic effects of GLP-2 on the gastrointestinal mucosa, though no definitive causal link to increased cancer risk was established across the reviewed studies.