BACKGROUND AND AIM: Teduglutide is a glucagon-like peptide-2 analogue used to promote intestinal rehabilitation and decrease the dependence from intravenous supplementation (IVS) in patients with short bowel syndrome and intestinal failure (SBS-IF). The aim of this study was to gain a better understanding of international real-world Teduglutide use since its launch. METHODS: Data from an international multicenter database for chronic IF were analysed. All the adult patients with SBS-IF included by centers that treated at least one patient with Teduglutide during the study period (2015-2022) were investigated. The baseline characteristics and the outcome of patients treated with Teduglutide (n.269) were compared to those of patients not receiving the drug (Controls, n.3081). The center experience was categorized based on the number of patients treated with Teduglutide: <
10 or ≥10. RESULTS: Teduglutide cohort exhibited higher male prevalence, younger age, longer duration of HPN, higher percentage of SBS with jejunocolonic anastomosis, lower IVS volume, improved oral intake, and higher percentage of patients weaned from IVS. Controls showed higher percentages of patients deceased or lost to follow up. Centers with ≥10 patients treated with Teduglutide showed higher weaning rates and lower mortality rates. CONCLUSIONS: This is the largest analysis of Teduglutide's real-world setting in SBS-IF. Clinicians preferentially selected for treatment patients with better prognostic indicators. Outcomes were significantly better in centers with higher Teduglutide treatment volumes, emphasizing the need for specialized referral centers to optimize care for SBS-IF patients.