Thursday, 30 April 2009

Chrons Disease and Remicade

So what it Remicade?

  • First off it is important to note that Remicade is the brand name of the generic medication called infliximab.
  • Infliximab (Remicade) is an antibody that attaches to a protein called tumor necrosis factor-alpha (TNF-alpha). TNF-alpha is one of the proteins produced by immune cells during activation of the immune system. TNF-alpha, in turn, stimulates other cells of the immune system to produce and release other proteins that promote inflammation.
  • Remicade is used to treat Crohn's disease, rheumatoid arthritis, as well as other conditions that cause inflammation.

How Does Remicade help people with Chrons Disease?

  • In Chrons disease, there is continued production of TNF-alpha as part of the immune activation. Remicade (Infliximab) attaches to TNF-alpha and blocks its activity and in so doing decreases the inflammation.
  • So Remicade helps put Crohn's into remission by neutralizing TNF-alpha. Remicade is therefore called a TNF "antagonist" that works with your body's immune system to block TNF-alpha, reducing inflammation
  • It is now generally agreed that people with chrons who respond well to an initial dose of Remicade will typically continue to improve with more treatments. If a patient does not respond to an initial dosage of Remicade, he or she is unlikely to respond with further treatment.
  • The people who respond well to Remicade, the improvements in symptoms can excellent, with rapid healing of the ulcers and the inflammation in the intestines after just one infusion.
  • Remicade has also been shown to be effective for treating anal fistulas.

How is Remicade (Infliximab) Made?

Infliximab is produced by the immune system of mice. The process involves injecting mice with with human TNF-alpha, the mouse antibody then is modified to make it look more like a human antibody, this is done to decrease the chances of an allergic reactions when it is given to humans. This modified antibody is infliximab.

What are the Side effects of Remicade (Infliximab)?

Remicade suppresses the immune system, generally the medication is well tollerated by the body, but it can have serious side effects and patients must be carefully monitored throughout the treatment.
  • Because infliximab is partly a mouse protein, it may induce an immune reaction when given to people with Chrons Diseas, especially with repeated infusions.
  • There is also the possibility of a delayed allergic reaction that occurs a week to ten days after receiving the infliximab.
  • There have been a few cases of side effects during the infusions, including chest pain, shortness of breath, and nausea.
  • Rare cases of nerve inflammation such as inflammation of the nerve of the eye (optic neuritis )
So whilst Remicade represents an exciting new development in the fight against Chrons disease, the long-term safety and effectiveness of infliximab is not yet known.

Tuesday, 14 April 2009

Chrons Disease and Pregnancy

It was not long ago that women with chrons disease were encouraged against pregnancy, but advances in the knowledge of Chrons disease and it's treatments mean that it is now safer than ever for women with chrons to get pregnant.

Studies have shown that the severity of the Chrons symptoms that are present in the mother at the time conception often continue throughout pregnancy. So if you have Chrons disease and are planning on having a baby the advice is to get the Chron's disease under control and in remission before getting pregnant. This can also give you time to get your body ready for pregnancy as most women even without chrons should do: by increasing the intake of folic acid, quitting smoking, getting more exercise and eating healthier.

Chrons Disease Drugs and Pregnancy
Naturally there are some chrons medications that are best avoided during the pregnancy, but now through research and a history of use, others are considered safe.

What drugs are not safe to take during pregncncy?
Two immunosuppressive drugs that are often used by chrons patients: Methotrexate and thalidomide should not be used during pregnancy. Thalidomide is well known for causing limb defects as well as other major organ complications in an unborn child, whilst the use of Methotrexate should be discontinued at least three months before conception as it has been known to cause abortion and skeletal abnormalities.

What drugs have been deemed safe for use during pregnancy?

So far the research has shown drugs commonly used in the treatment of chrons appear to be safe to take during pregnancy, these include: infliximab (Remicade), azathioprine (Imuran, Azasan), adalimumab (Humira) and certolizumab (Cimzia)

A few other drugs that are often used in Chrons disease flare-ups are also safe for pregnant women to use, these include: sulfasalazine (Azulfidine), forms of mesalamine (Asacol, Pentasa, Rowasa) and corticosteroids (Prednisone).

The best advice is to work very closely with your doctor that you are seeing for Crohn's disease as well as your obstetrician and your baby's pediatrician and don't be afraid to ask questions. As it is important point to remember that the biggest factor influencing a healthy pregnancy is the state of the chrons disease activity, so a well planned pregnancy when your chrons is in remission has the greatest chance for the best outcome.

Inflammatory bowel disease should be controlled prior to pregnancy: ulcerative colitis, Crohn's disease. (Women's Health).: An article from: Family Practice News