A Multicenter Study Demonstrates Efficacy And Tolerability Of A New Therapy In Patients With Moderate To Severe Ulcerative Colitis
Ulcerative colitis is a chronic inflammatory bowel disease that affects about 130,000 people in Italy. Disease management is complex and the therapies available today are effective only in a subset of patients, whose quality of life is often significantly compromised.
However, there is good news from the world of research: under the coordination of IRCCS Ospedale San Raffaele, an international consortium has tested the efficacy and safety of a new oral drug for patients with moderate to severe active ulcerative colitis. It is called upadacitiniband according to the results of the recently concluded clinical study a multicentre phase 3 trial it is able to reduce the intestinal inflammation characterizing the disease, thanks to the inhibition of various biological processes involved in the inflammatory cascade.
The study, published today in the prestigious journal The Lancet, was conducted in 199 institutes around the world and was coordinated by Silvio Danese, full professor of gastroenterology at Vita-Salute San Raffaele University and head of Gastroenterology and Digestive Endoscopy at IRCCS Ospedale San Raffaele in Milan.
Based on these results, the Committee for Medicinal Products for Human Use of the European Medicines Agency has released its positive opinion about the use of upadacitinib for the treatment of ulcerative colitis. The final decision by the European Commission is expected in the third quarter of 2022.
Good Bacteria Show Promise For Clinical Treatment Of Crohns Disease Ulcerative Colitis
May 28, 2021
Balfour Sartor, MD, Midget Distinguished Professor of Medicine, Microbiology and Immunology, is the senior author of a study that shows how a novel consortium of bacteria that live in the digestive tracts of healthy individuals can be used to prevent and treat aggressive colitis in humanized mouse models.
CHAPEL HILL, NC A new study published in Nature Communications demonstrates that a consortium of bacteria designed to complement missing or underrepresented functions in the imbalanced microbiome of inflammatory bowel disease patients, prevented and treated chronic immune-mediated colitis in humanized mouse models. The studys senior author, Balfour Sartor, MD, Midget Distinguished Professor of Medicine, Microbiology and Immunology, Co-Director of the UNC Multidisciplinary IBD Center, said the results are encouraging for future use treating Crohns disease and ulcerative colitis patients.
The idea with this treatment is to restore the normal function of the protective bacteria in the gut, targeting the source of IBD, instead of treating its symptoms with traditional immunosuppressants that can cause side effects like infections or tumors, Sartor said.
It also decreased pathobionts bacteria that can cause harm while expanding resident protective bacteria, and produced metabolites promoting mucosal healing and immunoregulatory responses, Sartor said. Simply put the treatment increased the good guys and decreased the bad guys.
What You Need To Know
Zeposia is an oral medication taken once a day. The dose is 0.92 milligrams.
Dr. Rudolph Bedford, a gastroenterologist at Providence Saint Johns Health Center in Santa Monica, told Healthline that Zeposia is a potential game changer for people with ulcerative colitis who dont respond to traditional therapies.
Traditional therapies include aminosalicylates along with corticosteroids and immunomodulators. Theyre all oral therapies, but quite often theres no response or an ineffective response, so we move on to biologics, he said.
Zeposia is a sphingosine 1-phosphate receptor modulator.
In ulcerative colitis and Crohns disease, T-cells attack the mucosal lining of the colon. This modulator regulates how that process occurs, Bedford explained. By essentially eliminating T-cells from moving into the lining of the colon, it prevents an inflammatory response with bleeding, diarrhea, and everything else that goes along with ulcerative colitis.
Weve been looking forward to oral medications coming out that are completely different from what were used to, he said. Im not sure its a first-line therapy at this point, but there will likely be more studies looking at this in naïve patients. I suspect that eventually the medical community will start to embrace it.
However, Zeposia isnt for everyone with ulcerative colitis.
The drug was also contraindicated in those who have:
- Mobitz type II second-degree or third degree atrioventricular block
- sick sinus syndrome
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Tofacitinib: New Drug Approved For The Treatment Of Patients With Ulcerative Colitis
Ulcerative colitis is a chronic inflammatory disease that affects the colonic mucosa. There is no curative treatment. Instead, patients must take medication to control the inflammation over the course of their lives. There are some patients whose condition cannot be sufficiently controlled by the drugs currently available. For them, the new treatment with tofacitinib could be an alternative.
In 2017, the European Medicines Agency approved tofacitinib for the treatment of ulcerative colitis in adult patients who presented an intolerance, insufficient response or loss of response to conventional treatment or biological medical products , which are also commonly administered to treat ulcerative colitis.
Tofacitinibs mechanism of action is different to all other currently approved molecules: it inhibits a route of inflammation known as JAK . Inhibiting this route of action represents a new approach in the treatment of ulcerative colitis.
This treatment has many advantages in terms of its administration: it is administered orally, and this encourages patients to accept and follow the treatment. Furthermore, it has a fast onset of action, the effect of the drug only lasts for a few hours in the body, there is no risk of producing antibodies against it and it is used in monotherapy, in other words, there is no need to combine it with other drugs.
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Diagnostic Et Traitement De La Colite Ulcreuse
Il n’y a pas de remède contre la colite ulcéreuse, mais des changements de mode de vie et des médicaments peuvent aider à gérer les poussées. Pour confirmer un diagnostic de colite ulcéreuse et exclure d’autres affections présentant des symptômes similaires, un patient peut subir un ou plusieurs des tests suivants :
- Prise de sang : Un test sanguin peut être utilisé pour vérifier l’anémie ou des signes d’infection.
- Test d’échantillon de selles : Un test de laboratoire d’un échantillon de selles d’un patient peut vérifier l’inflammation du côlon et exclure une infection causée par une bactérie, un parasite ou un virus.
- Coloscopie: Dans ce test, un médecin utilise un tube mince et éclairé pour examiner la muqueuse du côlon afin de rechercher des ulcères, des saignements ou des excroissances anormales.
- Biopsie: Une biopsie peut être effectuée dans le cadre d’une procédure d’endoscopie ou de coloscopie pour examiner un échantillon de tissu.
- Tests d’imagerie: Une radiographie ou un scanner peuvent être recommandés pour exclure d’autres conditions et vérifier l’inflammation du côlon.
Un certain nombre de médicaments peuvent aider à traiter la colite ulcéreuse. Ceux-ci inclus:
- Médicaments anti-inflammatoires
- Médicaments anti-diarrhéiques
- Pilules antispasmodiques, qui réduisent les crampes
Certaines modifications du mode de vie peuvent aider à atténuer les symptômes de la colite ulcéreuse, telles que :
Examination Of The Antioxidative Mechanism Of The Si
Figure 7
Si-based agent suppressed the intestinal oxidation associated UC via antioxidant sulfur compounds. Sulfur index analysis of the mouse large intestine. The average bar graphs for the expression of glutathione, oxidized glutathione, and each persulfide . White: control or con-DSS group black: Si or Si-DSS group. Contributory compounds in sulfur-index analysis. The dot graph of individual values and the average for sulfur index analysis. Data are expressed as mean±SEM of six mice per group. p< 0.08, *p< 0.05, **p< 0.01, determined by Students paired t-test.
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How To Cope With The 12 Worst Ulcerative Colitis Treatment Symptoms
According to Medscape, ulcerative colitis creates ulcers in the large intestine. The Crohns & Colitis Foundation says UC is caused by your immune system fighting an old infection. White blood cells assault your colon without bacteria or viruses to combat, producing pus-filled ulcers. Mucus release induces inflammation, which increases bowel movements.
Fda Approves New Drug For Ulcerative Colitis
- Federal regulators have approved the new drug Zeposia for treating moderate to severe ulcerative colitis in adults.
- The medication is the latest in a line of drugs used to treat symptoms of this particular type of inflammatory bowel disease .
- Clinical trials are under way to test Zeposias effectiveness in treating Crohns disease.
If youre living with ulcerative colitis, you may have a new treatment option.
On May 27, Bristol Myers Squibb officials announced that the Food and Drug Administration approved Zeposia for treatment of moderate to severe active ulcerative colitis in adults.
Ulcerative colitis is a chronic inflammatory bowel disease . Symptoms such as abdominal pain, diarrhea, and malnutrition can affect a persons quality of life.
Currently, the only potential cure for ulcerative colitis is surgery to remove the colon. But there are several types of medications to help manage the disease.
An estimated 3 million adults in the United States have been diagnosed with ulcerative colitis or Crohns disease, another type of IBD.
The FDA approved Zeposia in 2020 as a disease-modifying therapy for adults with relapsing forms of multiple sclerosis. And phase 3 trials are under way to evaluate the safety and efficacy of Zeposia for treating Crohns disease.
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Statins May Be Effective Treatment For Patients With Ulcerative Colitis
People with ulcerative colitis who are also taking statins have about a 50% decreased risk of colectomies and hospitalization, according to a Stanford Medicine study.
Ulcerative colitis causes inflammation and ulcers in the bowel, leaving patients vulnerable to an array of unpleasant symptoms, including abdominal pain, blood in the stool, constipation and fatigue.
There may be good news for the nearly 1 million people battling ulcerative colitis, a type of inflammatory bowel condition with no real cure: Statins, a commonly prescribed cholesterol-lowering drug, seem to be an effective, if unexpected, treatment for the condition, according to a new Stanford Medicine study.
Currently, the only lines of defense against ulcerative colitis are anti-inflammatory drugs, which dont always work, and a colectomy, the surgical removal of part or all of the colon. Discovering another option is significant, said Purvesh Khatri, PhD, associate professor of medicine and of biomedical data science, who led the research.
About 30% of ulcerative colitis patients eventually have to undergo a colectomy as a last resort. Its a drastic measure youre removing part of your body, said Khatri. So we thought, Can we use available data to see whether drugs that are already approved by the FDA can be repurposed to better treat these patients?
Does This New Ulcerative Colitis Treatment Have Any Side Effects
Like any other drug, RINVOQ too has adverse effects. No matter how insignificant, it is vital to know the side effects of the drug before taking it.
We present to you the side effects of Rinvoq, so read them carefully!
- Respiratory Tract Infections
- increased blood levels of creatine phosphokinase
- allergic reactions
- a lower number of certain types of white blood cells
- increased blood cholesterol levels
- increased liver enzyme levels
Note: RINVOQ is the latest ulcerative colitis treatment approved by the FDA. The above mentioned are only the known side effects of it as of now. There might be more adverse effects yet to be recognized.
There are many other factors you should know before considering RINVOQ.
We have discussed them below!
What do patients need to know before taking Rinvoq?
Note: The Rinviq medication dosage your doctor prescribes depends on several factors, including the frequency and severity of your problem and other health conditions. Taking any medication requires the advice of a doctor.
Question and Answers
Dr. Ankita Mago
Dr. Pallab Haldar
Good morning sir My son 6 years old age ,he is suffering from cyclical vomiting cyndrome from last 3 years ,but now he is some better comparative to previous years,but he has frequently stomach upset,then loose motions come,then vomitings occurred.what should he ate again vomiting occurred.please help us sir.Thanking you
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Ulcerative Colitis Treatment: Medication
The most common medication option is anti-inflammatory drugs. These can be used orally or topically to reduce inflammation of the colon and rectum.
Treating ulcerative colitis is a highly individualized process. At Johns Hopkins, we tailor your treatment to your specific needs and alter the medication as necessary. Your specific medication regimen will depend largely on the severity of your condition.
Other medications include:
-
Immunosuppressive medications: These drugs slow your immune system to stop the immune response that is causing the colon and rectum to swell.
-
Biologics: Like immunosuppressive medications, biologics target the immune system, but biologics act on specific immune system proteins that encourage inflammation.
The 3 Key Goals Of Uc Treatment
There are treatments available that can help control excess inflammation in order to help you:
Controlling inflammation can help relieve UC symptoms such as frequent and urgent bowel movements, bloody stools, and abdominal pain.
Controlling inflammation can also help you achieve and maintain remission. This means you have achieved ongoing symptom relief and are able to prevent flares.
Controlling inflammation over time allows the lining of the colon to heal and can help you maintain remission.
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What Happens If I Cannot Afford My Recommended Treatment
There are several options to reduce the cost of IBD treatments. Your doctor can work with you to see if the drug manufacturer offers patient financial assistance programs that provide medication at a discounted cost. Additionally, your doctor may work with your insurance company to prescribe more affordable biosimilars .
In some cases, missing doses of medication may lead to the development of antidrug antibodies, which can make a patient vulnerable to serious allergic reactions when the medication is restarted. Additionally, medication gaps can make patients with IBD more susceptible to flares and complications, including surgery and hospitalization. For these reasons, it is important to work with your doctor, insurance company, and the manufacturer of any medication you are on to minimize gaps in medication dosing.
Crohns and ulcerative colitis are lifelong, chronic conditions. However, when remission is achieved, most people have an excellent quality of life. Additionally, every patients symptom course is unique. If you are concerned about medication costs or safety, or are considering stopping your medications, reach out to your doctor to discuss a personalized solution for you.
About the Authors
Nisa Desai, MD, Contributor
How Do Doctors Treat Symptoms And Complications Of Ulcerative Colitis
Doctors may recommend or prescribe other treatments for symptoms or complications of ulcerative colitis. Talk with your doctor before taking any over-the-counter medicines.
To treat mild pain, doctors may recommend acetaminophen instead of nonsteroidal anti-inflammatory drugs . People with ulcerative colitis should avoid taking NSAIDs for pain because these medicines can make symptoms worse.
To prevent or slow loss of bone mass and osteoporosis, doctors may recommend calcium and vitamin D supplements or medicines, if needed. For safety reasons, talk with your doctor before using dietary supplements or any other complementary or alternative medicines or practices.
Doctors most often treat severe complications in a hospital. Doctors may give
- antibiotics, if severe ulcerative colitis or complications lead to infection
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Ulcerative Colitis: Bacteria Findings Raise Hopes For New Treatment
Sufferers found to have low levels of gut microbes that convert bile acids into other substances
Hopes of developing a new treatment for ulcerative colitis have been raised by research suggesting the condition may be linked to low levels of certain bacteria in the gut.
Ulcerative colitis is a long-term condition in which the colon becomes inflamed. According to the NHS, it is thought to be an autoimmune disease and affects one in every 420 people in the UK. Sufferers need to empty their bowels frequently, develop ulcers in their colon and have recurring bouts of diarrhoea with blood and pus in the faeces.
While a number of medicines can help manage the condition, ulcerative colitis can only be cured by removing the colon. However, about half of those who have this surgery go on to have inflammation in the area of the small intestine that is reconstructed into a pouch to serve as a rectum. Such inflammation is treated with antibiotics.
Now researchers say patients who have had this surgery for ulcerative colitis have lower levels of certain acids in their faeces, and fewer of the bacteria that produce them, than those who have had the surgery for other reasons.
The team say the results shed light on why the latter have a far lower risk of inflammation in their pouch. They say it also offers insights into ulcerative colitis itself, with experiments in mice suggesting inflammatory bowel diseases could be treated by introducing these missing acids into the colon.
Doctors Who Treat Ulcerative Colitis
Cleveland Clinic recommends beginning UC treatment with your usual doctor. If more testing is needed, theyll refer you to a gastroenterologist or colorectal surgeon for a colonoscopy. A gastroenterologist treats digestive issues. Colorectal surgeons conduct colon and rectum procedures. GIs manage UC treatment.
Other doctors will also help. A nutritionist will ensure you eat things your body can handle and obtain enough nutrientsa dermatologist for skin disorders and a rheumatologist for joint difficulties. Living with a chronic ailment is difficult therefore, physicians suggest visiting a psychologist for depression or anxiety. A third of UC patients require colorectal surgery.
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The Crohns & Colitis Foundation advises choosing a UC specialist carefully. Check that the doctor accepts your insurance, is nearby, and has a good bedside manner.
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