Immune System Drugs Help IBD
May 19, 2004 (New Orleans) — New medicines — ranging from a
relative of Viagra to an arthritis drug — target the haywire immune responses
that underlie inflammatory bowel disease (IBD).
Inflammatory bowel disease is the umbrella term for a number of
conditions that cause inflammation of the bowel. The two most common ones are
ulcerative colitis and Crohn’s disease. Both of these conditions occur when the
immune system goes awry and attacks the lining of the colon. The disorders take
a toll on their victims - affecting more than 1 million in the U.S. alone –
causing belly aches, diarrhea, and other symptoms that are often severe enough
to interfere with daily activities, says James B. Lewis, MD, associate director
of the inflammatory disease program at the University of Pennsylvania in
Philadelphia.
“We’re seeing many different approaches to treat this
inflammation,” says Stephen B. Hanauer, MD, professor of medicine and
clinical pharmacology at the University of Chicago Pritzker School of Medicine.
“For example, [corticosteroids] already used to treat IBD, are effective
anti-inflammatory agents but they affect all tissues, causing many side
effects.”
Many of the new drugs, on the other hand, selectively target
the defects associated with IBD — an approach that promises better results
with fewer side effects, he tells WebMD.
There were a number of new approaches discussed here at
Digestive Disease Week, a major medical meeting of gastroenterologists.
Arthritis Medication Combats Crohn’s, too
The rheumatoid arthritis drug Humira helped patients with
moderate Crohn’s disease to go into remission, Hanauer says.
A man-made biological substance called a monoclonal antibody,
Humira works by blocking an inflammation-causing protein called tumor necrosis
factor alpha, or TNF-alpha, that has been implicated in both rheumatoid
arthritis and Crohn’s disease.
In a study of nearly 300 patients who did not improve despite
treatment with standard medications, 30% of those given higher doses of Humira
were in remission by four weeks later, compared with only 12% on placebo,
Hanauer reports.
Humira is an injectable drug and was extremely well tolerated,
he says.
New Immune System Drug Antibody Prevents Crohn’s Flare-Ups
In another new study, the drug Antegren helped prevent
flare-ups associated with Crohn’s disease in people who were in remission,
reports Brian G. Feagan, MD, professor of medicine in the department of
epidemiology and biostatistics at the University of Western Ontario in
London.
The drug has already been shown to induce remission in Crohn’s
sufferers.
Antegren works by keeping immune system cells from leaving the
bloodstream. In Crohn’s patients, this appears to prevent the immune system
attack on the gut that occurs with the disease, Feagan says. “If we can
prevent that, white blood cells would stay in the circulation where they
belong.”
The researchers studied 339 adults with Crohn’s disease who had
improved or gone into remission after receiving three infusions of Antegren.
The patients were randomly assigned to continue to receive Antegren for up to
12 additional monthly infusions, or to placebo.
Six months later, 44% of patients given Antegren were still in
remission, compared with 26% on placebo, Feagan says. Also, 61% of those taking
the drug continued to show an improvement in symptoms, compared with 29% on
placebo.
People who took Antegren were no more likely to suffer side
effects than those on placebo, he explains.
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