Safer and more effective way to treat Crohn's disease

Feb 21, 2008

An international research study, published in The Lancet, has thrown into question the current method of treating Crohn’s disease – opening the door to a safer and more effective treatment option for sufferers of the chronic disease.

“Our study clearly demonstrated that this alternative treatment method was more effective at inducing disease remission than the conventional method,” said Dr. Brian Feagan, Director of Robarts Clinical Trials at Robarts Research Institute at The University of Western Ontario. Dr. Feagan coordinated the research trial and is an author on the study. “Not only were patients more likely to get their disease under control, but they were also spared exposure to steroids – the extended use of which is linked with metabolic disease and even increased mortality. It’s simply a safer, more effective treatment method.”

Called a "step-up" approach, the conventional treatment for Crohn’s disease involves first administering steroids in order to control the patient’s symptoms (abdominal pain and bloody diarrhea); the next step involves administering immune-suppressing drugs, which prepare the body to receive the third medication – an antibody that curbs the inflammatory response at the root of the disease.

The alternative strategy, called "top-down" therapy, employs early use of immune-suppressing drugs combined with an antibody in order to address the disease from the start. Symptom-treating steroids may never even be needed.

The two-year study was conducted at research centres in Belgium, Holland, and Germany and involved 129 subjects with active Crohn’s disease. 64 patients received the conventional step-up treatment and 65 the combined immune-suppressing method (top-down). 60% of the top-down subjects were symptom-free by the 26th week of the study, compared to only 36% of the step-up subjects.

“This study is a milestone in the management of Crohn’s disease,” said lead author Dr. Geert D’Haens, of the Imelda GI Clinical Research Centre at the Imelda Hospital in Bonheiden, Belgium. “It does not look at the effects of single drug intervention but at strategies to alter the natural history of this chronic destructive condition. All ‘classic’ paradigms for the management of Crohn’s disease need to be questioned.”

The impact of the study goes beyond Crohn’s disease. “We’ve seen similar results in top-down, step-up studies of rheumatoid arthritis,” said Dr. Feagan, “suggesting that the top-down approach could be the best treatment method for other chronic auto-immune diseases such as ulcerative colitis.”

Source: University of Western Ontario

Explore further: Ebola cases to triple to 20,000 by November unless efforts raised: WHO

add to favorites email to friend print save as pdf

Related Stories

Researchers create living human gut-on-a-chip

Mar 27, 2012

Researchers at the Wyss Institute for Biologically Inspired Engineering at Harvard University have created a gut-on-a-chip microdevice lined by living human cells that mimics the structure, physiology, and mechanics of the ...

Recommended for you

Sierra Leone, Liberia brace for new Ebola cases

10 hours ago

Two of the West African nations hardest hit by Ebola were bracing for new caseloads on Monday after trying to outflank the outbreak with a nationwide checkup and a large new clinic.

Reversing the effects of pulmonary fibrosis

10 hours ago

Yale University researchers are studying a potential new treatment that reverses the effects of pulmonary fibrosis, a respiratory disease in which scars develop in the lungs and severely hamper breathing.

User comments : 2

Adjust slider to filter visible comments by rank

Display comments: newest first

bigwheel
5 / 5 (1) Feb 21, 2008
this is a big deal, if you ever meet someone with crones you'll
understand why.
blubbber
not rated yet Feb 22, 2008
Even better news: Low-dose naltrexone therapy improves active Crohn's disease. PubMed 17222320
http://www.ncbi.n...17222320

CONCLUSIONS: LDN therapy appears effective and safe in subjects with active Crohn's disease. Further studies are needed to explore the use of this compound. Penn State is conducting trials http://www.hmc.ps...one.htm)