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Recent preclinical data indicate that acute GVHD causes a loss of intestinal neuroendocrine L-cells leading to reduced levels of glucagon-like peptide-2 (GLP-2). GLP-2 substitution improved GVHD severity and increased Paneth cells and intestinal stem cells in mice. This motivated us to treat patients with refractory intestinal aGHVD using the GLP-2-analogon teduglutide. In this retrospective multicenter survey, 17 patients received teduglutide as salvage-therapy for SR-intestinal aGVHD. The best response (CR or PR) at any time point during and after treatment was 64.7% (11\/17) including 41.2% (7\/17) CR and 23.5% (4\/17) PR. At a median follow-up of 28 weeks after teduglutide 10\/17 patients are alive. Most patients experienced an increase of the albumin serum level within 2 months after the first teduglutide dose, including patients who clinically did not respond to teduglutide treatment. No specific teduglutide-related toxicity was observed. Our retrospective analysis suggests that teduglutide is safe and has activity in a fraction of patients with intestinal SR-aGVHD, which needs validation in a prospective trial.<\/jats:p>","DOI":"10.1038\/s41409-025-02586-2","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T07:02:37Z","timestamp":1744614157000},"page":"873-878","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Teduglutide for treatment-refractory severe intestinal acute graft-versus-host disease - a multicenter survey"],"prefix":"10.1038","volume":"60","author":[{"given":"Niklas","family":"Brehm","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Biavasco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2729-9706","authenticated-orcid":false,"given":"Johannes","family":"Clausen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0137-7929","authenticated-orcid":false,"given":"Johannes","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1788-2807","authenticated-orcid":false,"given":"Kristina","family":"Maas-Bauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0813-3444","authenticated-orcid":false,"given":"Ralph","family":"W\u00e4sch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mareike","family":"Verbeek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Nuernbergk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8091-1589","authenticated-orcid":false,"given":"Gabriele","family":"Ihorst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Seropian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1799-5927","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Finke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lohith","family":"Gowda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakefet","family":"Sidlik Muskatel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00e9gis","family":"Peffault de Latour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2114-7533","authenticated-orcid":false,"given":"G\u00e9rard","family":"Socie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5037-6175","authenticated-orcid":false,"given":"Claudia","family":"Wehr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4553-3065","authenticated-orcid":false,"given":"David","family":"Michonneau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6565-3393","authenticated-orcid":false,"given":"Robert","family":"Zeiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"2586_CR1","doi-asserted-by":"publisher","first-page":"2167","DOI":"10.1056\/NEJMra1609337","volume":"377","author":"R Zeiser","year":"2017","unstructured":"Zeiser R, Blazar BR. 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DM: has received research grants from Novartis, CSL Behring and Sanofi, received consulting fees from Novartis, Incyte, Mallinckrodt and Sanofi, honoraria for lectures, presentations, speakers\u2019 bureaus, manuscript writing, or educational events from Jazz Pharmaceuticals. He has received support for attending meetings and\/or travel from Novartis and Sanofi. He has participated in a Data Safety Monitoring Board or Advisory Board for Incyte and Sanofi. GI: none for this work. JC: received speakers fees and research funding from Novartis and Takeda. JF: none for this work. JJ: none for this work. RPL: Expert consultant \/ speaker: Alexion, Amgen, Apellis, Jazz, Novartis, Pfizer, Roche & Samsung - Research grant: Alexion, Novartis and Pfizer. RW: received honoraria from Abbvie, Alexion Amgen, BMS, Janssen, Kite\/Gilead, Pfizer Sanofi, Takeda. RZ: received speakers fees from Incyte, Novartis, Sanofi, Medac and Mallinckrodt\/Therakos. The other authors have no conflict of interest with this manuscript to disclose.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}