A recent statement in a CNN.com article by two experts in Crohn’s disease and ulcerative colitis ought to bring a measure of optimism to anyone dealing with either of these two major inflammatory bowel diseases.
Specifically with Crohn’s disease, “ ... there have been tremendous advances in our understanding of this condition,” wrote Dr. David T. Rubin, co-director of the Inflammatory Bowel Disease Center at the University of Chicago, and Dr. Corey A. Siegel, director of the IBD Center at Dartmouth-Hitchcock Medical Center.
“ ... our current options and approach to treatments provide much more certainty of success and much less fear of the unknown,” added the doctors in the August 15, 2012, article.
Furthermore, there has been an “explosion” of scientific discoveries in the last 10 years that zero in on possible genetic and environmental causes of Crohn’s disease, they said.
With continued medical advances, the chronic nature of Crohn’s disease and ulcerative colitis -- the often-lifelong battle against bowel flare-ups and the resulting pain, fatigue and malnutrition -- might become less of an issue.
Repeated intestinal surgeries might be avoided as well.
The doctors said that, as with other inflammatory diseases, the goal is early treatment and effective strategies to put IBD in remission, rather than “chasing symptoms and trying to play catch up.”
As the article noted, new drug therapies have recently been approved by the Food and Drug Administration.
One treatment gaining ground is biologic therapies, as opposed to the more common corticosteroid therapies.
As the site for the Crohn’s & Colitis Foundation of America explains, biologics are medications made from living organisms, using proteins, genes and antibodies. Biologics are genetically engineered to go after the proteins and enzymes that are tied to inflammation.
IBD patients may know these biologics by their scientific names. These are adalimumab, certolizumab pegol, infliximab and natalizumab.
Their ability to act selectively on the molecules causing inflammation sets them apart from corticosteroids, which tend to suppress the entire immune system and which can result in major side effects.
Depending on the medication, a biologic might be administered intravenously at the hospital or by self-injection, in intervals ranging from every other week to every other month.
There can be side effects, such as swelling at the injection site, headaches, nausea and respiratory problems.
The biologic therapy adalimumab (HUMIRA, Abbott) was recently given the go-ahead by an FDA advisory panel as a treatment for ulcerative colitis, in addition to Crohn’s disease. It is expected to be approved by the FDA by the end of the year.
Whatever the recommended treatment, patients should take heart that doctors’ knowledge of IBD is growing, said Rubin and Siegel.
“People living with Crohn's disease should now expect to live their lives with good disease control and (be) able to achieve all that they desire, including having children and a living a normal life expectancy.”
Rubin and Siegel said they expect at least two new therapies to be approved by the FDA within the next two years, adding that new research is focused on the benefits of disease monitoring and individualized treatments.
“FDA advisers OK Humira to treat ulcerative colitis.” ChicagoTribune.com. Web. 3 Sept. 2012.
Rubin, David, and Corey Siegel. “New treatments offer hope for Crohn’s patients.” CNN.com. Web. 3 Sept. 2012.
“Biologic Therapies.” Crohn’s & Colitis Foundation of America. Web. 3 Sept. 2012.
Reviewed September 4, 2012
by Michele Blacksberg RN
Edited by Jody Smith