-- Canadian researcher among principal investigators in international
LONDON, ON, Feb. 22 /CNW/ - An international research study, published
today in The Lancet, has thrown the current method of treating Crohn's disease
into question - opening the door to a safer and more effective treatment
option for sufferers of the chronic disease. The study aimed to compare the
effectiveness of early use of combined immunosuppression with infliximab with
conventional management in patients with active Crohn's disease who had not
previously received glucocorticoids, antimetabolites, or infliximab.
"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 - to which the extended use of is linked with
metabolic disease and even increased mortality. This alternative treatment
method is simply a safer, more effective treatment method."
The alternative treatment strategy, called "top-down" therapy, employs
early use of immune-suppressing drugs combined with infliximab, an antibody,
in order to address the disease from the start. With this treatment method,
symptom-treating steroids may not even be needed.
The conventional treatment for Crohn's disease, called a "step-up"
approach, 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 two-year study was conducted at research centres in Belgium, Holland,
and Germany and involved 129 subjects with active Crohn's disease. Sixty-four
patients received the conventional step-up treatment and 65 the combined
immune-suppressing method (top-down). Sixty per cent of the top-down subjects
were symptom-free by the 26th week of the study, compared to only 36 per cent
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. "This suggests that the top-down approach could be the best
treatment method for other chronic auto-immune diseases, such as ulcerative
Dr. Feagan is a Professor of Medicine and Epidemiology & Biostatistics at
the Schulich School of Medicine & Dentistry at Western. He holds
cross-appointments in the Divisions of Internal Medicine, Clinical
Pharmacology and Gastroenterology.
Advance interviews with Dr. Feagan and a Crohn's disease patient can be
arranged by contacting: Anthea Rowe, Robarts Research Institute,
Kathy Wallis, Schulich School of Medicine & Dentistry,
Andrea Herman, Cohn & Wolfe, 416-924-5700 ext. 4020 or
Gastroenterologist and lead author Dr. Geert D'Haens is available for
interviews by email and telephone any time: email@example.com or
Robarts Research Institute - accelerating medical discovery
For further information:
For further information: Advance interviews with Dr. Feagan and a
Crohn's disease patient can be arranged by contacting: Anthea Rowe, Robarts
Research Institute, (519) 663-3524; Kathy Wallis, Schulich School of Medicine
& Dentistry, (519) 661-2111 x81136; Andrea Herman, Cohn & Wolfe, (416)
924-5700 ext. 4020 or firstname.lastname@example.org; Gastroenterologist and lead
author Dr. Geert D'Haens is available for interviews by email and telephone
any time: email@example.com or +32474987756