RxPG News Feed for RxPG News

Medical Research Health Special Topics World
  Home
 
   Health
 Aging
 Asian Health
 Events
 Fitness
 Food & Nutrition
 Happiness
 Men's Health
 Mental Health
 Occupational Health
 Parenting
 Public Health
 Sleep Hygiene
 Women's Health
 
   Healthcare
 Africa
 Australia
 Canada Healthcare
 China Healthcare
 India Healthcare
 New Zealand
 South Africa
 UK
 USA
 World Healthcare
 
 Latest Research
 Aging
 Alternative Medicine
 Anaethesia
 Biochemistry
 Biotechnology
 Cancer
 Cardiology
 Clinical Trials
 Cytology
 Dental
 Dermatology
 Embryology
 Endocrinology
 ENT
 Environment
 Epidemiology
 Gastroenterology
 Genetics
 Gynaecology
 Haematology
 Immunology
 Infectious Diseases
 Medicine
 Metabolism
 Microbiology
 Musculoskeletal
 Nephrology
 Neurosciences
 Obstetrics
 Ophthalmology
 Orthopedics
 Paediatrics
 Pathology
 Pharmacology
 Physiology
 Physiotherapy
 Psychiatry
 Radiology
 Rheumatology
 Sports Medicine
 Surgery
 Toxicology
 Urology
 
   Medical News
 Awards & Prizes
 Epidemics
 Launch
 Opinion
 Professionals
 
   Special Topics
 Ethics
 Euthanasia
 Evolution
 Feature
 Odd Medical News
 Climate

Last Updated: Feb 19, 2013 - 1:22:36 AM
Research Article
Latest Research Channel

subscribe to Latest Research newsletter
Latest Research

   EMAIL   |   PRINT
Early introduction of biologic therapy improves Crohn's disease outcomes

Apr 17, 2012 - 4:00:00 AM
The Food and Drug Administration approved the first targeted biologic therapy for Crohn's disease in 1998 and the second two in 2007 and 2008. Rubin said physicians are hesitant to prescribe them earlier because they are expensive, must be administered through injections instead of pills and are typically saved until last,. Patients and doctors are nervous about immune suppressive therapies. The perception in the current treatment algorithm is that the therapies saved for last must also be the most dangerous, he said. But that's the wrong thinking, and by delaying their prescription it may be a self-fulfilling prophecy because by then patients have suffered more damage to their bowels and are less likely to respond favorably.

 
[RxPG] A large-scale study of medical claims data shows that introducing sophisticated biologic therapies early in the course of treatment for Crohn's disease improves response to medication and reduces the need for surgery.

There is no known cure for Crohn's disease, and traditional treatment is focused on a step-up strategy of managing inflammatory symptoms, starting with simpler and less costly oral medications such as aminosalicylates (5-ASAs) and corticosteroids, and escalating through a series of steps to more expensive biological therapies that target specific proteins in the immune system's inflammatory response.

David Rubin, MD, associate professor of medicine and co-director of the University of Chicago Medicine's Inflammatory Bowel Disease Center, studied a newer top-down strategy that reverses this order of treatment. He found that patients treated with biologic therapies earlier were significantly less likely to need steroids, lose response to their biologic therapy, and require surgery related to their Crohn's disease. We're essentially reversing the management strategy in Crohn's disease, Rubin said.

He emphasized that the medications often used first for patients with Crohn's are also the least effective and carry risks for side effects. We've long discussed and debated that 5-ASAs don't work in the majority of Crohn's patients, and certainly don't change any outcomes, he said. Steroids are ineffective long-term and are also dangerous because they have significant side effects such as infections.

Crohn's is a disorder in which the body's immune system appears to have lost the ability to regulate itself and becomes overactive, causing progressive damage to the bowel structure and function. Patients often need bowel surgery to repair this damage. Researchers have made great progress finding genetic and environmental contributors to Crohn's disease, but the actual cause is unknown.

Rubin said that physicians have questioned the effectiveness of the step-up strategy because patients experience little relief while being treated with medications before they receive the biological therapies. During that time, they suffer from active disease, have low rates of remission and often appear to lose response to the biological therapies.

In recent years a treatment strategy that starts with the targeted biologic therapy as a first option has been explored in controlled clinical trials. The encouraging results suggested that such an approach results in higher remission rates. However, it was not clear whether this top-down approach would translate to the general population of patients with Crohn's disease, or whether such an approach would maintain the response to biologic therapy and decrease the need for surgery.

The Food and Drug Administration approved the first targeted biologic therapy for Crohn's disease in 1998 and the second two in 2007 and 2008. Rubin said physicians are hesitant to prescribe them earlier because they are expensive, must be administered through injections instead of pills and are typically saved until last,. Patients and doctors are nervous about immune suppressive therapies. The perception in the current treatment algorithm is that the therapies saved for last must also be the most dangerous, he said. But that's the wrong thinking, and by delaying their prescription it may be a self-fulfilling prophecy because by then patients have suffered more damage to their bowels and are less likely to respond favorably.

In the study, published in the journal



Related Latest Research News
Drug activates virus against cancer
Bone loss associated with increased production of ROS
Sound preconditioning prevents ototoxic drug-induced hearing loss in mice
Crystal methamphetamine use by street youth increases risk of injecting drugs
Johns Hopkins-led study shows increased life expectancy among family caregivers
Moderate to severe psoriasis linked to chronic kidney disease, say experts
Licensing deal marks coming of age for University of Washington, University of Alabama-Birmingham
Simple blood or urine test to identify blinding disease
Physician job satisfaction driven by quality of patient care
Book explores undiscovered economics of everyday life

Subscribe to Latest Research Newsletter

Enter your email address:


 Feedback
For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page

 
Contact us

RxPG Online

Nerve

 

    Full Text RSS

© All rights reserved by RxPG Medical Solutions Private Limited (India)