Sunday, 24 February 2008

Chrons Disease and Aggressive Therapy

A recent study has shown that if you treat chrons disease more aggressively, it resulted in a better outcome for patients. This study was performed by an international team of researchers.

The researcher's found that shortly after a person had been diagnosed with chrons disease, using more than 1 immunosuppressive drug was more effective in inducing remission than starting patients on corticosteroids.

One of the researcher's, Dr. Brian Feagan said that more studies needed to be conducted, but if you treat chrons patients earlier with more aggressive therapy it may be more effective than the traditional method. Doctors are always looking for ways to treat people who suffer from chrons disease without the use of steroids, so this could mean en exciting development.
Nobody really knows the true cause of chrons disease but basically what happens is there is an inflammation of the gut that often affects the small intestine, the swelling leads to pain and diarrhea. The current theory is that someone with crohn's disease has lost tolerance to normal bacteria in the gastrointestinal tract. "The immune system is in a controlled inflammatory state. In Crohns disease, it is thought that the immune system is becoming unhappy with normal flora. White blood cells migrate into the tissue and release nasty things and cause damage." said Feagan, director of Robarts Clinical Trials at Robarts Research Institute at The University of Western Ontario in London, Ontario, Canada.

The current usual treatment for someone with crohns begins with corticosteroids. If the patient shows really bad side effects to the steroid treatment or if some sort of resistance to the drug begins to show the treatment usually moves on to a range of immunosuppressive drugs like Rheumatrex (methotrexate). If this treatment does not help, tumor necrosis factor (TNF)-blockers are often then used.

Remicade (infliximab) with Imuran (azathioprine)
In the research 133 people with chrons disease in Belgium, Germany and Holland had either combined immunosuppression or the traditional method. 67 had the joint immunosuppression with three infusions of Remicade (infliximab) with Imuran (azathioprine) at the start and then again a few weeks later and then again 4 weeks after that. The other 66 patients were given steroids ad then given Imuran and Remicade.

Study Results
Some initial findings show that after 6 months sixty percent of the patients on the combined immunosuppression had their chrons disease in remission with no need for steroids or any form of surgery. From the second group only 35.9% were in remission.

Later on, after one year the figures were:
61.5% of the combined immunosuppression group were in remission compared to ony 42.2 % of patients following the more traditional method of chrons disease treatments.

More research is to follow, but if they come to the same conclusion, the conventional treatment for Chrons could change.

Down sides to Remicade (infliximab)
Remicade is administered intravenously so the person has to go to a medical center to receive treatment.

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