Patients with severe bowel disease may benefit from a new drug that can eliminate their troubling symptoms in as little as three months.
Etrasimod once a day treats ulcerative colitis by binding to immune cells and preventing them from accidentally attacking healthy tissue in the lining of the gut.
In a recent study, 27 percent of patients who had not responded to other treatment were found to be in remission after just 12 weeks, and 32 percent were symptom-free after one year.
Ulcerative colitis can be debilitating, causing bloody diarrhea, extreme fatigue, loss of appetite, and weight loss.
It can also cause symptoms such as abdominal pain and digestive discomfort – similar to the more common problem of irritable bowel syndrome (IBS).
Once-daily tablet etrasimod treats ulcerative colitis by binding to immune cells and preventing them from accidentally attacking healthy tissue in the lining of the gut
dr. Sami Hoque, a gastroenterologist at Barts Health NHS Trust in London who led the UK arm of the etrasimod study, described the results as “astonishing”.
He added: ‘When I started treatment for ulcerative colitis, there were very few options available, and what we did have caused serious side effects. The advantage of etrasimod is that it is highly selective and is able to target unruly inflammatory cells without affecting the immune system as a whole.
It is an important adjunct to existing treatments for bowel disease and, unlike other therapies that involve injections, it comes as a once-a-day tablet. This puts the power in the hands of patients, allowing them to avoid regular visits to the hospital.’
Ulcerative colitis is a long-term condition that occurs when, for reasons not fully understood, the immune system overworks and attacks healthy body tissue in the lining of the colon or colon, causing inflammation and ulcers. It is one of the two main types of inflammatory bowel disease, along with Crohn’s disease.
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The condition affects around 146,000 people in the UK, but experts suggest many more may go undiagnosed and as many as one in ten people over 50 may have some form of the disease.
Patients can go without symptoms for months before being hit by a flare-up. During these episodes, some patients also experience painful joints, mouth ulcers, and irritated red eyes. In the most severe cases, they may also experience shortness of breath, palpitations, and fever.
If doctors suspect colitis, they first take a stool sample to test for a protein called calprotectin — a sign of inflammation in the gut.
If there is a positive result, a gastroenterologist will perform further tests to look for physical signs of damage. This usually involves a colonoscopy, in which a camera is inserted into the back passage and tissue is excised for testing.
The first-line treatment includes tablets or suppositories containing anti-inflammatory drugs called aminosalicylates. These help control mild flare-ups, but their effect wears off over time.
Other options include powerful steroids that reduce inflammation, but come with the risk of unpleasant side effects such as acne, mood swings, and diabetes. Drugs that suppress the immune system can also be used, but these can leave patients vulnerable to infections.
If these options fail, as in 15 percent of cases, surgery to remove the bowel may be the only option.
dr. Hoque said: ‘Etrasimod can be used in combination with existing treatments to boost the body’s defenses and avoid the need for surgery.’
The drug has not yet been approved. However, experts hope the process will begin later this year.
Romit Zutshi, 42, from Chigwell in Essex, was diagnosed with bowel disease in 2015 and has been treated with etrasimod as part of the Barts trial.
The married father of one first went to see his GP after he started seeing blood in his stool and had to go to the bathroom up to eight times a day.
He said, “Not knowing what was wrong with me was scary. I started to lose weight and was constantly tired because I woke up in the night to run to the toilet.”
Unresponsive to other drugs, he took part in the etrasimod study at Barts in 2020 and noticed “a drastic improvement.”
He added: ‘I feel more confident and can live more or less like a normal person. Before, I was constantly worried about being near a toilet when I left the house and I couldn’t exercise properly because I got tired so quickly, but that’s no longer a problem.’
WEIRD SCIENCE: Homemade drug left man with fungus in his veins
At the hospital, tests showed that the man’s liver and kidneys were failing because the fungus psilocybe cubensis grew in his blood.
A man developed a life-threatening yeast infection after mushrooms started growing in his bloodstream.
The 30-year-old American told doctors that he had been trying to find a way to treat his mental health problems.
After reading that psilocybin, a hallucinogenic compound found in magic mushrooms, can help cancer patients with anxiety and depression, he boiled them into a tea and injected it.
In the following days he became nauseous, confused and began vomiting blood.
At the hospital, tests showed that his liver and kidneys were failing because the fungus psilocybe cubensis was growing in his blood.
The man spent 22 days in the hospital, eight of which were in intensive care, with his blood filtered and two courses of antibiotics, according to the Journal Of The Academy Of Consultation-Liaison Psychiatry.
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