How Do GLP-2 Analogs Work?

Glucagon-like peptide (GLP)-2 analogs are a class of drugs used for the prevention or treatment of patients with short bowel syndrome (SBS) who need intravenous nutrition and fluids. The glucagon-like peptides (GLP-1 and GLP-2) are 33-amino acid peptide hormone released from enteroendocrine cells of the gut in response to nutrient ingestion. These hormones help regulate your appetite, especially after eating. They also help in enhancing the production of insulin. These hormones can be found as soon as 10 minutes after eating. GLP-1 stays in the body hours after eating and circulates in the blood. GLP-2 regulates gastric motility, gastric acid secretion, and intestinal hexose transport and increases the barrier function of the gut epithelium.

SBS is a group of problems related to poor absorption of nutrients. The small intestine is where most of the nutrients you eat are absorbed into the body during digestion. SBS can occur when portions of the small intestine are missing or damaged at birth or have been surgically removed. Common signs and symptoms of SBS may include:

• Diarrhea
• Greasy, foul-smelling stools
• Fatigue
• Weight loss
• Malnutrition
• Swelling (edema) in the lower extremities

GLP-2 analogs are administered via intravenous route or injected subcutaneously (under the skin). It is usually injected once a day. Their safety and efficacy in children below 1 year of age are unknown.

GLP-2 analogs work in the following ways:

• They are analogs of naturally occurring human GLP-2 hormone.
• GLP-2 increases intestinal and portal blood flow and inhibits gastric acid secretion. 
• They improve the intestinal absorption of fluids and nutrients.
• They bind to the GLP-2 receptors located in the enteroendocrine cells, subepithelial myofibroblasts, and enteric neurons of the submucosal and myenteric plexus.
• This causes the release of insulin-like growth factor-1, nitric oxide, and keratinocyte growth factor.
• These growth factors may contribute to the increase in crypt cell growth and surface area of the gastric mucosa. Ultimately, absorption through the intestine is enhanced.

GLP-2 analogs are used to treat SBS in people who need additional nutrition or fluids from intravenous therapy.

Common side effects include:

• Abdominal pain/distension
• Gastrointestinal stoma complication (an opening in the abdomen that allows waste to exit the body, rather than going through the digestive system)
• Nausea
• Vomiting
• Headache
• Injection site reactions
• Flatulence (gas)
• Decreased appetite

Other rare side effects include:

• Cough/flu-like symptoms
• Trouble sleeping
• Severe constipation
• Unusual tiredness
• Swelling of the feet or ankles
• Rapid weight gain
• Trouble breathing

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of GLP-2 analogs drugs include:

• Gattex
• Teduglutide