Crohn's: New Treatments, Better Understanding

Currently there are many symptomatic treatments for Crohn's, but there is no cure. The cause of the illness isn't known, which makes finding effective treatments or a cure nearly impossible. Current types of treatment include antibiotics, anti-inflammatory drugs, immunomodulators, biologic therapies and in some cases nutritional therapies.

When Remicade TM (infliximab) first came on the market, it brought relief to many Crohn's patients. Infliximab modifies the human immune system. It is an antibody produced in mice after they're infected with a protein called tumor necrosis factor-alpha (TNF-alpha). Antibodies to TNF-alpha are then taken from the mouse, and they become infliximab after being adjusted to be more like human antibodies in order to avoid allergic reactions or rejections in patients. It's given as an IV. Many doctors feel it hasn't been studied enough, and should not be used as a long-term drug.

More recently a similar anti-TNF agent has come on the market: Humira TM (adalimumab). It doesn't use a "middle-mouse" like Remicade does. Instead, it is completely human in origin. It's administered by a shot, or subcutaneous injection, instead of intravenously as with Remicade. It's been in use for some time by rheumatologists treating illnesses like rheumatoid arthritis and ankylosing spondylitis. Like Remicade, it treats the inflammation of the small intestine, and can help to prevent the on-set of a flare. It is commonly used in patients who can no longer tolerate infliximab.

A recent study funded by the National Institutes of Health (NIH) tried the drug naltrexone, used to treat addictions to alcohol and opioid drugs, on Crohn's patients. They found that a daily dose of 4.5 mg for twelve weeks helped reduce symptoms and improve the quality of life of those patients. The researchers admitted that they don't yet know how it works in Crohn's patients, and that more study is needed. It has potential for future treatment, as it has fewer side effects than most other drugs in use, is less expensive than most, and is safer for long-term use.