# Defining pediatric intestinal failure natural history

> **NIH FDA R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2024 · $1,515,663

## Abstract

Pediatric intestinal failure (IF) is a rare condition that affects under 25,000 individuals in the United States.
Children with IF require parenteral nutrition to provide enough calories at a critical period of life, for growth and
development. IF is associated with high morbidity and mortality and transplant-free survival has been
estimated to be 70% at 5 years. IF can be classified into two broad categories. In short bowel syndrome (SBS-
IF), children have insufficient intestinal length to absorb enough nutrients for growth. The remaining functioning
intestine may adapt over time to accommodate this diminished length, but only half of these children reach
enteral autonomy, the state of no longer requiring any parenteral nutrition. To augment the adaptation process,
hormonal therapy has been tried. The lone approved hormonal therapy carries a high cost with only a small
fraction of children reaching enteral autonomy. The second category, functional IF, results from defects in either
absorption of nutrients into enterocytes or intestinal motility. No medical therapy exists to treat functional IF
disorders, resulting in lifelong parenteral nutrition dependence. The lack of adequate therapies in pediatric
IF results in large part due to the extreme rarity of this condition and the associated dearth of available
high-quality natural history data to be utilized in drug development and clinical trials. Moreover, study
endpoints have focused on freedom from parenteral nutrition and survival without consideration of quality of life
and additional meaningful disease specific outcome measures. This study will utilize the infrastructure of
the existing International Intestinal Failure Registry (IIFR) to overcome these gaps and support new
drug development in IF. The IIFR completed a successful pilot phase (N=204) in 2021 and currently
prospectively follows nearly 400 children with IF. Participating study sites account for 170 current patients with
an annual estimate of 183 new patients per year. In Aim 1, we will audit the ongoing prospective data collection
on demographics, clinical characteristics, nutrition, genotype, and outcomes in children with both SBS-IF (Aim
1a) and functional IF (Aim 1b) to verify data quality. In Aim 2, in collaboration with our stakeholder team, we will
incorporate a novel IF community-derived patient-reported outcome measure into the registry. In Aim 3, we will
utilize an IF community-derived set of core outcomes to develop a classification method for risk stratification
using machine learning methods. The result will be a longitudinal registry of high-quality patient data that
can be used to support therapeutic development with built-in tools to assess patient-reported
outcomes and risk stratify patients for future trials. In SBS-IF, this will provide the necessary standard of
care comparison for several products currently being evaluated. In functional IF, this will provide novel
genotype-phenotype correlation data to suppor...

## Key facts

- **NIH application ID:** 11034310
- **Project number:** 1R01FD007597-01A1
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Yaron Avitzur
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** FDA
- **Fiscal year:** 2024
- **Award amount:** $1,515,663
- **Award type:** 1
- **Project period:** 2024-09-05 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11034310

## Citation

> US National Institutes of Health, RePORTER application 11034310, Defining pediatric intestinal failure natural history (1R01FD007597-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/11034310. Licensed CC0.

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