A preliminary trial has revealed that an investigational medicine can prevent celiac disease-induced intestinal damage, boosting hopes that it could become the first therapy for severe digestive ailment.
New Medication For Celiac Disease
When a genetically vulnerable individual consumes gluten – a protein found in wheat, rye, and barley — the immune system assaults the lining of the small intestine.
Celiac disease symptoms include diarrhea, stomach discomfort, tiredness, and weight loss. Underlying it all is an abnormal immune system attack that destroys villi, which are hair-like structures in the gut lining. Because villi absorb nutrients from food, persons with celiac disease might become malnourished and suffer issues like anemia and bone weakening.
According to senior researcher Dr. Detlef Schuppan, the sole therapy at the moment is strict avoidance of even trace amounts of gluten in the daily diet.
However, according to Schuppan, a professor at Johannes Gutenberg University’s University Medical Center in Germany, a lifetime gluten-free diet is difficult to maintain.
Gluten may be found in a variety of processed foods, including pasta and morning cereals, sauces and soups, energy bars, and chips.
The rigorous diet is not just a practical hardship but also a social and psychological one, according to Schuppan.
Even if patients manage to stick to it, he says, some may still experience gut inflammation and symptoms.
The latest study published on July 1 in the New England Journal of Medicine investigated whether an investigational medication may prevent such intestinal damage.
According to Schuppan, the medication ZED1227 inhibits the action of an enzyme called transglutaminase 2 (TG2) in the intestines. TG2 is important in the immunological response that characterizes celiac disease.
The research, sponsored by Dr. Falk Pharma, included 163 people with celiac disease who had been successful with a gluten-free diet for at least a year.
The patients were randomly allocated to one of four groups: three received varying dosages of ZED1227 to take every morning for six weeks, while the fourth received dummy tablets.
The research participants ate a biscuit containing a moderate quantity of gluten thirty minutes after each morning dosage to assess the drug’s potential to prevent gluten-induced inflammation.
The research discovered that patients on any dose of the medication exhibited fewer symptoms of intestinal damage after six weeks compared to the placebo group. In terms of adverse effects, skin rash was the only one prevalent among drug users, occurring in 8% of patients on the highest dose.
Dr. Joseph Murray, a gastroenterologist at the Mayo Clinic, deemed the results positive.
According to Murray, a medical advisor to the Celiac Disease Foundation, the experiment demonstrates that inhibiting this crucial enzyme is possible.
Larger trials would be needed to determine whether this reduces symptoms and improves the quality of life in patients, according to Murray.
He, like Schuppan, observed that gluten-free diets are difficult to maintain and are not often sufficient on their own.
According to Murray, over 30% of patients continue to have significant problems despite doing their best on a gluten-free diet.
Future studies will be focused on these patients. In addition, Schuppan stated that his team is developing a trial to examine ZED1227 in celiac disease patients who are not responding fully to a gluten-free diet.
If ZED1227 or another medication for celiac disease becomes available, the gluten-free diet will not be abolished.
According to Murray, patients would most likely still need to adhere to dietary restrictions. However, given the difficulties of eliminating gluten, he believes medicine should make people’s life simpler.
According to Murray, there is real optimism that they will have more therapies for celiac disease, which has hitherto placed the whole weight of care on the patient.
According to the Celiac Disease Foundation, celiac disease affects around 1% of the world’s population. It is estimated that 2.5 million persons in the United States are undiagnosed.